Which findings on ECG suggest ORT in Wolff-Parkinson-White (WPW) syndrome?

Updated: Jan 08, 2017
  • Author: Christopher R Ellis, MD, FACC, FHRS; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

A critically timed premature atrial beat that occurs during the refractory period of the AP typically initiates ORT. The impulse, therefore, travels solely down the AV node but returns in a retrograde manner through the AP, resulting in reciprocating tachycardia.

This is a narrow-complex heart rhythm limited by the refractory period of the AV node. The QRS complex is narrow, because the impulses travel in an antegrade manner (orthodromically) through the AV node, and regular, because circus (circular) movement occurs at a regular rate.


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