Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases

Introduction: Fasciculoventricular (FV) accessory pathways are rare variants of preexcitation syndrome and published data on the ECG of FV pathways are limited. The purpose of this study was to analyze the electrocardiographic characteristics of FV pathways. Methods: We enrolled 5 patients (mean age...

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Main Authors: Akihiro Saito, MD, Yoshiaki Kaneko, MD PhD, Tadashi Nakajima, MD PhD, Tadanobu Irie, MD, Masaki Ota, MD, Toshimitsu Kato, MD, Takafumi Iijima, MD, Toshio Ito, MD, Mamoru Manita, MD PhD, Masahiko Kurabayashi, MD PhD
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Journal of Arrhythmia
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1880427610800055
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author Akihiro Saito, MD
Yoshiaki Kaneko, MD PhD
Tadashi Nakajima, MD PhD
Tadanobu Irie, MD
Masaki Ota, MD
Toshimitsu Kato, MD
Takafumi Iijima, MD
Toshio Ito, MD
Mamoru Manita, MD PhD
Masahiko Kurabayashi, MD PhD
author_facet Akihiro Saito, MD
Yoshiaki Kaneko, MD PhD
Tadashi Nakajima, MD PhD
Tadanobu Irie, MD
Masaki Ota, MD
Toshimitsu Kato, MD
Takafumi Iijima, MD
Toshio Ito, MD
Mamoru Manita, MD PhD
Masahiko Kurabayashi, MD PhD
author_sort Akihiro Saito, MD
collection DOAJ
description Introduction: Fasciculoventricular (FV) accessory pathways are rare variants of preexcitation syndrome and published data on the ECG of FV pathways are limited. The purpose of this study was to analyze the electrocardiographic characteristics of FV pathways. Methods: We enrolled 5 patients (mean age, 26.8 ± 15.1 years; range 15–49 years, 2 male) with FV pathways which were diagnosed based on the standard electrophysiologic criteria. According to the standard criteria for the ECG classification of manifest Wolff-Parkinson-White (WPW) syndrome, the ECGs were classified as type A, B or C. The polarity of delta wave in each lead of each patient was divided into positive, flat or negative and was applied to the stepwise ECG algorithms of atrioventricular accessory pathway previously published by Fitzpatrick, Arruda and Iturralde. Results: Type A was found in one patient (Case No 4), type B in one patient (Case No 5) and type C in three patients (Case No 1, 2 and 3). Based on stepwise ECG algorithm, all cases corresponded to the polarity of the delta wave in patients with right anteroseptal, posteroseptal, right anterolateral or left anterolateral AP. In all three cases exhibiting type C, the polarity of delta wave in lead V2 was flat. Conclusions: ECGs of FV pathways may be misidentified as ECG of WPW syndrome, and may present with any preexcitation pattern of type A, B or C.
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spelling doaj.art-90f695fcd948446ebed3fb0e5e2354402022-12-22T00:43:35ZengWileyJournal of Arrhythmia1880-42762010-01-0126318118810.1016/S1880-4276(10)80005-5Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five CasesAkihiro Saito, MDYoshiaki Kaneko, MD PhDTadashi Nakajima, MD PhDTadanobu Irie, MDMasaki Ota, MDToshimitsu Kato, MDTakafumi Iijima, MDToshio Ito, MDMamoru Manita, MD PhDMasahiko Kurabayashi, MD PhDIntroduction: Fasciculoventricular (FV) accessory pathways are rare variants of preexcitation syndrome and published data on the ECG of FV pathways are limited. The purpose of this study was to analyze the electrocardiographic characteristics of FV pathways. Methods: We enrolled 5 patients (mean age, 26.8 ± 15.1 years; range 15–49 years, 2 male) with FV pathways which were diagnosed based on the standard electrophysiologic criteria. According to the standard criteria for the ECG classification of manifest Wolff-Parkinson-White (WPW) syndrome, the ECGs were classified as type A, B or C. The polarity of delta wave in each lead of each patient was divided into positive, flat or negative and was applied to the stepwise ECG algorithms of atrioventricular accessory pathway previously published by Fitzpatrick, Arruda and Iturralde. Results: Type A was found in one patient (Case No 4), type B in one patient (Case No 5) and type C in three patients (Case No 1, 2 and 3). Based on stepwise ECG algorithm, all cases corresponded to the polarity of the delta wave in patients with right anteroseptal, posteroseptal, right anterolateral or left anterolateral AP. In all three cases exhibiting type C, the polarity of delta wave in lead V2 was flat. Conclusions: ECGs of FV pathways may be misidentified as ECG of WPW syndrome, and may present with any preexcitation pattern of type A, B or C.http://www.sciencedirect.com/science/article/pii/S1880427610800055Variant preexcitationWolff-Parkinson-White syndromeMahaim fiberDelta wave
spellingShingle Akihiro Saito, MD
Yoshiaki Kaneko, MD PhD
Tadashi Nakajima, MD PhD
Tadanobu Irie, MD
Masaki Ota, MD
Toshimitsu Kato, MD
Takafumi Iijima, MD
Toshio Ito, MD
Mamoru Manita, MD PhD
Masahiko Kurabayashi, MD PhD
Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
Journal of Arrhythmia
Variant preexcitation
Wolff-Parkinson-White syndrome
Mahaim fiber
Delta wave
title Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
title_full Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
title_fullStr Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
title_full_unstemmed Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
title_short Electrocardiographic Characteristics of Fasciculoventricular Pathways: Analysis of Five Cases
title_sort electrocardiographic characteristics of fasciculoventricular pathways analysis of five cases
topic Variant preexcitation
Wolff-Parkinson-White syndrome
Mahaim fiber
Delta wave
url http://www.sciencedirect.com/science/article/pii/S1880427610800055
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