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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
OLMEDO, Julián Andrés et al. Electrocardiographic characteristics of fasciculo-ventricular accessory pathways in children: A comparative study with right anteroseptal accessory pathways. Arch. Cardiol. Méx. [online]. 2018, vol.88, n.3, pp.212-218. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2017.05.003.
Objectives:
Fasciculo-ventricular (FV) accessory pathways (AP’s) and right anteroseptal (RAS) AP’s share similar anatomic locations and electrocardiographic characteristics. The objective of this article is to compare these features in children.
Methods:
All patients with manifest pre-excitation who underwent an electrophysiological study were included. Fasciculo-ventricular AP’s were defined by the presence of an HV inter- val ≤ 32 ms and a prolongation of the AH without changes in the HV interval, or the level of pre-excitation during atrial pacing. Three independent and blind observers analysed the ECG’s in both groups.
Results:
Out of 288 patients, 15 (5.2%) had FV AP’s and 14 (4.9%) right AS AP’s. The PR interval was longer in FV AP’s than in RAS (113 ± 21 vs 86 ± 13 ms respectively; P < .001) and the QRS was narrower (95 ± 12 vs 137 ± 24 ms respectively; P < .001). The ECG in patients with FV AP’s showed a rapid low amplitude deflection at the begining of the QRS in 13 out of 15 patients (87%) and in 2 (14%) the RAS AP group (P = .003).
Conclusions:
The PR interval was longer and the QRS complex was narrower in patients with FV AP’s. The presence of a rapid low amplitude deflection at the beginning of the QRS complex would allow to differentiate them from RAS AP’s non-invasively.
Keywords : Fasciculo-ventricular accessory pathways; WPW syndrome; Children; Argentina.