PMID: 8945082Nov 1, 1996Paper

Electrocardiographic identification of mid-septal accessory pathways in close proximity to the atrioventricular conduction system

Pacing and Clinical Electrophysiology : PACE
A Lorga FilhoP Brugada

Abstract

In order to identify ECG characteristics of overt mid-septal accessory pathways (APs) predictive of close proximity to the AV conduction system we analyzed data from patients who underwent successful RF catheter ablation of a mid-septal AP. Mean patient age was 31 +/- 16 years, and 13 were male. The 40 degrees right anterior oblique view was used to divide the mid-septal area into 3 zones: 1 (anterior portion); 2 (intermediate); and 3 (posterior portion). The 12-lead ECG was analyzed with regard to delta wave polarity and R/S transition in the precordial leads. The findings from patients ablated at zone 3 were compared to those at zones 1 and 2. All patients had a positive delta wave in the leads I, II, aVL, and negative delta wave in the leads III and aVR. The R/S transition occurred in lead V2 in 80% of patients. The delta wave in lead aVF was the only ECG characteristic that correlated with the AP ablation zone. Six of 8 patients ablated at zone 3 had a negative delta wave in lead aVF while 6 out of 7 patients ablated at zone 1 or 2 had a positive or isoelectric delta wave in lead aVF (P = 0.03). A positive or isoelectric delta wave in lead aVF identifies mid-septal AP in close proximity to the AV conduction system.

References

Aug 1, 1995·Pacing and Clinical Electrophysiology : PACE·A P Fitzpatrick
Jan 1, 1994·Journal of the American College of Cardiology·A P FitzpatrickM M Scheinman

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Citations

Mar 30, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hamid BastaniMats Jensen-Urstad
Oct 20, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·E González-TorrecillaF Fernández-Avilés
Oct 24, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Majid HaghjooMohammad Ali Sadr-Ameli
Aug 2, 2003·Journal of Cardiovascular Electrophysiology·Fiorenzo GaitaPierre Jais
Apr 8, 1999·Pacing and Clinical Electrophysiology : PACE·C T TaiM S Chang
Aug 29, 2001·Journal of Tongji Medical University = Tong Ji Yi Ke Da Xue Xue Bao·L WangK H Kuck
Jun 4, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
Aug 14, 2021·Journal of Arrhythmia·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group

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