How is the location of an accessory pathway (AP) identified 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...
  • Print
Answer

The location of the AP can often be determined through analysis of the spatial direction of the delta wave in the 12-lead ECG by reviewing the maximally preexcited QRS complexes. [28] A general rule is that Q waves (negative delta waves) point away from the earliest site of ventricular activation, which is typically the insertion point of the bypass tract. The most common locations for APs, in decreasing order of frequency, are the left free wall, the posteroseptal and right free wall, and finally the midseptal and anteroseptal regions of the heart.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!