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Kim, Kim, Oh, Oh, Lee, Park, Choi, Seo, and Lee: Value of P Wave in Determining the Site of Accessory Pathway during Orthodromic Atrioventricular Reentry Tachycardia
Original Article
Korean Circulation Journal

Korean Circulation Journal 1990; 20(1): 121-127.

Published online: 31 March 1990

DOI: https://doi.org/10.4070/kcj.1990.20.1.121

Value of P Wave in Determining the Site of Accessory Pathway during Orthodromic Atrioventricular Reentry Tachycardia

Chee Jeong Kim, M.D., Young Dae Kim, M.D., Dong Jin Oh, M.D., Byung Hee Oh, M.D., Myoung Mook Lee, M.D., Young Bae Park, M.D., Yun Shik Choi, M.D., Jung Don Seo, M.D., Young Woo Lee, M.D.

Copyright © 1990 The Korean Society of Circulation

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The P wave during orthodromic atrioventricular reentry tachycardial were analysed in 19 patients to evaluate the usefulness in identifying the location of accessory pathways.
The results were as follows;
1) Definitely inverted and upright P waves in lead I represented the left-sided and right-sided pathways respectively, but the converse is not necessarily true.
2) Dome and Dart appearance in lead VI(4 cases), upright P wave in inferior leads(3 cases), and negative P wave in aVL(3 cases) suggested the left-sided pathway and deeply inverted P waves in inferior leads suggested the posteroseptal or right-sided one.
3) In 17 cases(79%), inverted P wave appeared on more than one lead among the inferior leads, which were helpful to identify the position on P wave and mechanism of supraventricular tachycardia.
Although the number of cases especially with right-sided pathway was small to conclude, P wave was useful for determining the location of accessory pathway noninvasively.

Keywords: PSVT, Accessory pathway, P wave

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