Abstract
Atypical bypass tracts or variants of ventricular pre-excitation are rare anatomic structures often with rate-dependent slowing in conduction, called decremental conduction. During sinus rhythm, electrocardiographic recognition of those structures may be difficult because unlike in the Wolff-Parkinson-White syndrome where usually overt ventricular pre-excitation is present, the electrocardiogram (ECG) often shows a subtle pre-excitation pattern because of less contribution to ventricular activation over the slow and decrementally conducting bypass. Following the structure described by Ivan Mahaim and Benatt corresponding to a fasciculoventricular pathway, several other new variants of ventricular pre-excitation were reported. In this review, we aim to discuss the electrocardiographic pattern of the different subtypes of variants of ventricular pre-excitation, including the atriofascicular pathway, long and short decrementally conducting atrioventricular pathways, fasciculoventricular pathway, the atrio-Hisian bypass tract, and nodoventricular and nodofascicular fibres. Emphasis will be on the ECG findings during sinus rhythm.
Original language | English |
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Pages (from-to) | 208-218 |
Number of pages | 11 |
Journal | EP Europace |
Volume | 21 |
Issue number | 2 |
DOIs | |
Publication status | Published - 1 Feb 2019 |
Keywords
- accessory pathways
- algorithm
- arrhythmias
- atrioventricular-conduction
- atypical bypass tracts
- electrocardiogram
- electrocardiogram findings
- fasciculoventricular pathways
- natural-history
- nodoventricular mahaim fiber
- p-r interval
- parkinson-white-syndrome
- pre-excitation
- supraventricular tachycardia
- variants
- P-R INTERVAL
- ALGORITHM
- NATURAL-HISTORY
- Atypical bypass tracts
- ACCESSORY PATHWAYS
- ELECTROCARDIOGRAM
- Electrocardiogram findings
- FASCICULOVENTRICULAR PATHWAYS
- Pre-excitation
- SUPRAVENTRICULAR TACHYCARDIA
- PARKINSON-WHITE-SYNDROME
- Variants
- ATRIOVENTRICULAR-CONDUCTION
- NODOVENTRICULAR MAHAIM FIBER
- Arrhythmias