A new ECG sign of an accessory pathway in sinus rhythm: pseudo partial right bundle branch block.
It is clinically important to be able to detect the presence of an accessory pathway, as pre-excited atrial fibrillation is a well recognised cause of sudden cardiac death, for which there is a potential "cure" in the form of radiofrequency ablation of the pathway. The classic manifestations such as a shortened PR interval or delta waves may not always be present. In certain patients a pseudo partial right bundle block pattern-that is, an rSr' complex in lead V1- may be the sole manifestation of a left sided accessory pathway. An electrophysiological mechanism is proposed for this pattern and it is suggested that this pattern may be used as a new ECG sign for diagnosing an accessory pathway in sinus rhythm.
Department of Cardiology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. e.w.lau@bham.ac.uk
E W
EW
Lau
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Ng
M J
MJ
Griffith
D000328:Adult; D002037:Bundle-Branch Block / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male