Wolf-Parkinson-White Syndrome

Wolf-Parkinson-White is the syndrome of pre-excitation secondary to antegrade conduction down an accessory pathway from atrium to ventricle. This is characterized on the 12-lead surface ECG by a short PR interval, a delta wave and broad complexes (as a result of the delta wave). The accessory pathway can be in any location around the atrioventricular valves, i.e. mitral or tricuspid valves. Using various algorithms it is possible to accurately locate the position of the accessory pathway.

In this patient's case there is a dominantly upright QRS deflection in the right praecordial leads, resulting in tall R waves in leads V1 and V2. This is the picture of Type A WPW, where pre-excitation is usually of the left ventricle.

Lown-Ganon-Levine syndrome differs from Wolf-Parkinson-White syndrome in that it has a short PR interval without a delta wave. This is thought to be due to accessory conduction tissue from the atria to the atrioventricular node. Whilst the complexes are broad, this is clearly sinus rhythm and not ventriuclar tachcardia.