Initial forces of ventricular depolarization in the Wolff-Parkinson-White Syndrome. Analysis based upon localization of the accessory pathway by epicardial mapping.

Circulation
A M TonkinA G Wallace

Abstract

The epicardial activation sequence of 34 patients with the Wolff-Parkinson-White syndrome was determined. Epicardial pre-excitation occurred at a spectrum of sites over either the free wall of the left or right ventricle or in a paraseptal region, always adjacent to the atrioventricular rings. The site of pre-excitation was related to the spatial position of the 10 msec vector of the vectorcardiogram (VCG) in 15 patients and the 20 msec vector of the electrocardiogram (ECG) in 29 patients with a single accessory pathway. All patients whose 20 msec vector (ECG) was directed to the right had accessory pathways which caused epicardial breakthrough over the free wall of the left ventricle. When the 20 msec vector (ECG) was to the left and inferior, epicardial pre-excitation was over either the right ventricular free wall or in the region of the pulmonary outflow tract. Superior location of the initial forces, especially the 10 msec vector (VCG), strongly suggested the presence of a septal bypass tract. The polarity of the delta wave and maximum QRS forces in precordial lead V1 were discordant in a significant number of patients, pointing to probable shortcomings of a classification based upon the latter.

Citations

Mar 15, 1989·Journal of the American College of Cardiology·D M Cassidy, M E Cain
Jan 1, 1980·Journal of Electrocardiology·R GonzalezR W Peters
Jul 1, 1984·Journal of the American College of Cardiology·W F HeddleH J Wellens
Jan 1, 1985·Journal of the American College of Cardiology·B J DealA Garson
Oct 1, 1986·Journal of the American College of Cardiology·T C Chou
Oct 1, 1978·Pacing and Clinical Electrophysiology : PACE·A M Tonkin
Sep 1, 1990·Pacing and Clinical Electrophysiology : PACE·L A BockeriaI P Poljakova
May 1, 1977·British Heart Journal·P DenesK M Rosen
Oct 1, 1976·Australian and New Zealand Journal of Medicine·A M Tonkin
Jan 1, 1990·Annals of the New York Academy of Sciences·N C Flowers, L G Horan
Nov 1, 1979·The American Journal of Cardiology·A J BudaD C Harrison
Mar 1, 1981·The American Journal of Cardiology·R A BauernfeindK M Rosen
Sep 1, 1986·IEEE Transactions on Bio-medical Engineering·M Lorange, R M Gulrajani
Jan 1, 1978·Progress in Cardiovascular Diseases·J J GallagherA G Wallace
Jan 1, 1978·Journal of Electrocardiology·P W DuchosalJ Odier
Jan 1, 1979·Journal of Electrocardiology·H OguriT Ohta
Jan 1, 1988·Pacing and Clinical Electrophysiology : PACE·D L KucharJ N Ruskin
May 1, 1986·The American Journal of Cardiology·S MilsteinG J Klein
Jun 1, 1977·The American Journal of Cardiology·M E JosephsonJ G Kitchen
Sep 1, 1980·American Heart Journal·I Hoffman
Oct 1, 1976·Circulation·J J GallagherA G Wallace
May 1, 1977·Circulation·C R WyndhamK M Rosen
May 1, 1984·Pacing and Clinical Electrophysiology : PACE·R Yee, G J Klein
Sep 1, 1984·Pacing and Clinical Electrophysiology : PACE·F E Marchlinski, M E Josephson
Aug 3, 2007·Pacing and Clinical Electrophysiology : PACE·Andrew D McGaviganPeter W Macfarlane
Nov 1, 1984·Pacing and Clinical Electrophysiology : PACE·K K TalwarS B Olsson

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.