Surface Electrocardiogram in Ventricular Pre-excitation: How Reliable Is It To Locate the Site of Accessory Pathway?

  • E. Piccolo
  • P. Delise
  • S. Themistoclakis
Conference paper


It is estimated that about 3–4/1000 individuals are born with accessory pathway. These patients may have anterograde manifest conduction and hence show ventricular pre-excitation with short PR interval and delta waves (WPW electrocardiographic pattern). In some cases the accessory pathway may be concealed, manifesting only retrograde conduction over this tract. If so, the electrocardiogram is normal. In 5%–10% of series, multiple accessory pathways have been described.


Coronary Sinus Accessory Pathway Delta Wave Retrograde Conduction Leave Lateral 
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  1. 1.
    Rosenbaum F, Hect H, Wilson F, Johnston F (1945) The potential variation of the thorax and the oesophagus in anomalous atrioventricular excitation ( Wolff-Parkinson-White Syndrome ). Am Heart J 29: 281–288CrossRefGoogle Scholar
  2. 2.
    Milstein S, Sharma AD, Guiraudon GM, Klein GJ (1987) An algorithm for the electrocardiographic localization of accessory pathways in the Wolff-Parkinson-White Syndrome. Pace 10: 555–563PubMedCrossRefGoogle Scholar
  3. 3.
    Fitzpatrick AP, Gonzales RP, Lesh MD, Modin GW, Lee RJ, Scheinman MM (1994) New algorithm for localization of accessory atrioventricular connections using a baseline electrocardiogram. J Am Coll Cardiol 23: 107–116PubMedCrossRefGoogle Scholar
  4. 4.
    Rodriguez L, Smeet J, De Chillou C et al (1993). The 12-lead electrocardiogram in midseptal, anteroseptal, posteroseptal and right free wall accessory pathways. Am J Cardiol 72: 1274–1280PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • E. Piccolo
    • 1
  • P. Delise
    • 1
  • S. Themistoclakis
    • 1
  1. 1.Divisione di CardiologiaOspedale Umberto IMestre-VeniceItaly

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