Wolff-Parkinson-White syndrome EKG examples

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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EKG examples

Shown below is an EKG depicting delta waves in V1, V2, and aVF, coupled with short PR interval suggestive of WPW syndrome.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG depicting delta waves (slurred up-stroking QRS complex) in precordial leads, aVL, and aVF, wide QRS complexes, short PR interval and left axis deviation suggesting WPW syndrome. There is an rsr¹ pattern in the chest lead V1.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of Wolff-Parkinson-White syndrome (antero-lateral pathway) depicting delta waves in leads V3, V4, V5, and V6, wide QRS complexes (>110 ms) and short PR interval.

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Shown below is an EKG of type B Wolff-Parkinson-White syndrome depicting delta waves in leads I, aVL and V2-V6, short PR interval and non-specific ST changes.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of Wolff-Parkinson-White syndrome (epicardial pathway) depicting delta waves (slurred up-stroking QRS) in precordial leads with wide QRS complexes.

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Shown below is an EKG of Wolff-Parkinson-White syndrome (left posterior pathway) depicting in delta waves in V5 and V6 along with wide QRS complexes and short PR interval.

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Shown below is an EKG of Wolff-Parkinson-White syndrome (posteroseptal pathway) depicting delta waves in leads I and precordial leads along with wide QRS complexes, left axis deviation and non-specific ST changes.

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Shown below is an EKG showing abnormal QRS form with delta waves seen best in the precordial leads and shortening of PR interval signifying aberrant conduction pathway.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG showing delta waves in leads I, II, V4, and V5 and short PR interval in a patient with Wolff-Parkinson-White Syndrome.

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Shown below is an EKG of WPW syndrome depicting delta wave in leads II, V2-6 along with wide QRS complexes, short PR interval and rsr¹ pattern in V1.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of type A Wolff-Parkinson-White syndrome depicting delta waves in leads II, III, aVF, and in precordial leads along with wide QRS complexes, an rsr¹ pattern in the lead V1 and left axis deviation.

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Shown below is an EKG of WPW syndrome. EKG demonstrates a delta wave in the precordial leads, wide QRS complexes and short PR interval.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of type A WPW syndrome demonstrating delta waves in the precordial leads, wide QRS complexes (>110 milli sec), prominent R waves in leads V1 and V2.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type A demonstrating delta waves in the precordial leads and limb leads III and aVF along with tall R waves in V₁ and V₂.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type A demonstrating delta waves in precordial leads and limb leads II, III and aVF along with prominent R waves in leads V₁ and V₂ and Rsr pattern in lead V₁.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type B demonstrating delta waves along with prominent S wave in V₁, prominent R waves in left precordial leads, wide QRS complexes and left axis deviation.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type B demonstrating delta waves and short PR interval in limb leads I and aVL and chest leads V_{2 - 6} and prominent R waves in lateral chest leads. There is also left axis deviation.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type B demonstrating wide QRS complexes with delta waves and short PR interval in limb leads I and aVL and chest leads V_{2 - 6} and prominent S waves in lead V₁ and prominent R waves in lateral chest leads. There is also left axis deviation.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type B demonstrating wide QRS complexes with delta waves in limb leads I and II and chest leads V_{4 - 6} and prominent S waves in leads v₁ and V₂ and prominent R waves in lateral chest leads.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG of WPW syndrome type B demonstrating wide QRS complexes with delta waves and prominent S waves in leads v₁ and V₂ and prominent R waves in lateral chest leads.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG showing WPW syndrome with an orthodromic circus movement tachycardia (CMT): Narrow complex tachycardia with a rate of 200 bpm (RR interval 320 ms). After 5 cycles, the tachycardia suddenly stops and four multiform complexes are seen without any P waves. These complexes should be regarded as a polymorphic ventricular tachycardia, which is not uncommon after an adenosine-terminated supraventricular tachycardia. A 5th complex is preceded by a P wave. The subsequent 4 complexes show a widened QRS complex and all are immediately preceded by a P wave. The initial phase of the QRS complex is slurred and positive in all available leads. Sinus rhythm continues thereafter with gradual abbreviation of the QRS complex until a 120 msec wide QRS complex remains.

The same patient's EKG during sinus rhythm. A discrete delta wave is clearly visible. The morphology of the delta wave suggests a left posterior Kent bundle.

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Shown below is an EKG showing sinus rhythm with short PR interval (<120 ms) and the slurred upstroke of the QRS (delta wave). This is best seen in leads I and aVL, V2 to V6. Of interest is that the delta wave is negative in the inferior leads and gives the false impression of an inferior wall myocardial infarction. This tracing show WPW ventricular pre-excitation.

Copyleft image obtained courtesy of ECGpedia,http://en.ecgpedia.org/wiki/Main_Page

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Shown below is an EKG demonstrating delta waves in the precordial leads and limb leads I and aVL along with wide QRS, short PR interval and left axis deviation suggesting WPW syndrome. The accessory pathway is located in the left posteroseptal region.

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Shown below is an EKG depicting atrial flutter in a patient with WPW syndrome. There is 1:1 conduction down a bypass tract.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:ECG_Aflutt_1to1.jpg

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Sources

Copyleft images obtained courtesy of ECGpedia, http://en.ecgpedia.org/index.php?title=Special:NewFiles&offset=&limit=500