Premature ventricular contraction-induced concealed retrograde penetration: Electrocardiographic manifestations on anterograde ventricular preexcitation. 2018

Damián Longo, and Adrian Baranchuk
Division of Arrhythmia and Pacing, Complejo Médico Policial Churruca-Visca, Buenos Aires, AR, USA.

In patients with manifest anterograde ventricular preexcitation, the electrocardiographic manifestation of the anomalous conduction through the simultaneous conduction over the atrioventricular (AV) node and the accessory pathway ("delta wave"); depends on several factors, the most representative being the conduction velocity over one or another connection. Occasionally, ventricular ectopic beats may present with retrograde penetration over one or both conduction pathways (AV node and/or accessory pathway), impacting on the morphology of the next immediate anterogradely conducted QRS. We present a case of a young patient with WPW syndrome and ectopic ventricular beats with different manifestations on the postectopic QRS due to concealed penetration of different conduction pathways.

UI MeSH Term Description Entries
D008297 Male Males
D011226 Pre-Excitation Syndromes A group of conditions in which HEART VENTRICLE activation by the atrial impulse is faster than the normal impulse conduction from the SINOATRIAL NODE. In these pre-excitation syndromes, atrial impulses often bypass the ATRIOVENTRICULAR NODE delay and travel via ACCESSORY CONDUCTING PATHWAYS connecting the atrium directly to the BUNDLE OF HIS. Preexcitation Syndrome,Pre Excitation Syndromes,Pre-Excitation Syndrome,Preexcitation Syndromes
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006329 Heart Conduction System An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart. Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001283 Atrioventricular Node A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. AV Node,A-V Node,Atrio-Ventricular Node,A V Node,A-V Nodes,AV Nodes,Atrio Ventricular Node,Atrio-Ventricular Nodes,Atrioventricular Nodes,Node, A-V,Node, AV,Node, Atrio-Ventricular,Node, Atrioventricular,Nodes, A-V,Nodes, AV,Nodes, Atrio-Ventricular,Nodes, Atrioventricular
D015716 Electrocardiography, Ambulatory Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia. Ambulatory Electrocardiography,Electrocardiography, Dynamic,Electrocardiography, Holter,Holter ECG,Holter EKG,Holter Monitoring,Monitoring, Ambulatory Electrocardiographic,Monitoring, Holter,Ambulatory Electrocardiography Monitoring,Dynamic Electrocardiography,Electrocardiography Monitoring, Ambulatory,Holter Electrocardiography,Ambulatory Electrocardiographic Monitoring,ECG, Holter,ECGs, Holter,EKG, Holter,EKGs, Holter,Electrocardiographic Monitoring, Ambulatory,Holter ECGs,Holter EKGs,Monitoring, Ambulatory Electrocardiography
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017115 Catheter Ablation Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DC-shock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias. Ablation, Transvenous Electric,Catheter Ablation, Electric,Catheter Ablation, Percutaneous,Catheter Ablation, Radiofrequency,Catheter Ablation, Transvenous,Ablation, Catheter,Ablation, Transvenous Electrical,Catheter Ablation, Electrical,Electric Catheter Ablation,Electrical Catheter Ablation,Percutaneous Catheter Ablation,Radiofrequency Catheter Ablation,Transvenous Catheter Ablation,Ablation, Electric Catheter,Ablation, Electrical Catheter,Ablation, Percutaneous Catheter,Ablation, Radiofrequency Catheter,Ablation, Transvenous Catheter,Electric Ablation, Transvenous,Electrical Ablation, Transvenous,Transvenous Electric Ablation,Transvenous Electrical Ablation

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