Korean Circ J.  1990 Mar;20(1):121-127. 10.4070/kcj.1990.20.1.121.

Value of P Wave in Determining the Site of Accessory Pathway during Orthodromic Atrioventricular Reentry Tachycardia

• Kim CJ
• Kim YD
• Oh DJ
• Oh BH
• Lee MM
• Park YB
• Choi YS
• Seo JD
• Lee YW

• KMID: 2229393
• DOI: http://doi.org/10.4070/kcj.1990.20.1.121

Abstract

The P wave during orthodromic atrioventricular reentry tachycardial were analysed in 19 patients to evaluate the usefulness in identifying the location of accessory pathways. The results were as follows; 1) Definitely inverted and upright P waves in lead I represented the left-sided and right-sided pathways respectively, but the converse is not necessarily true. 2) Dome and Dart appearance in lead VI(4 cases), upright P wave in inferior leads(3 cases), and negative P wave in aVL(3 cases) suggested the left-sided pathway and deeply inverted P waves in inferior leads suggested the posteroseptal or right-sided one. 3) In 17 cases(79%), inverted P wave appeared on more than one lead among the inferior leads, which were helpful to identify the position on P wave and mechanism of supraventricular tachycardia. Although the number of cases especially with right-sided pathway was small to conclude, P wave was useful for determining the location of accessory pathway noninvasively.

Keyword

PSVT; Accessory pathway; P wave

MeSH Terms

Humans
Tachycardia*
Tachycardia, Supraventricular