[Usefulness of the thoracic circle in localizing the pre-excitation zone in Wolff-Parkinson-White syndrome]

Abstract

In this study thoracic circle lead electrocardiogram were recorded during sinus rhythm in 50 patients with Wolff Parkinson White Syndrome. We analyzed: delta wave polarity, QRS axis in the frontal plane, ventricular preexcitation, the pattern of precordial R wave transition and QRS morphology in the unipolar leads, also concordance between electrocardiographic patterns and the site of the accessory pathway determined during electrophysiological study. Electrocardiograms from patients with left lateral sites showed negative delta waves in leads LI or a VL, V7 to V9, positive delta waves in V3R to V9R, a normal QRS axis and early precordial R wave transition (20 of 23 patients). Left posterior sites manifested negative Delta waves in L3, a VF, V7 to V9, V7R to V9R and a prominent R wave in V1 (4 of 5 patients). Left posteroparaseptal sites had the same pattern plus negative delta waves in L2, a superior QRS axis, and RS or Rs morphology in V1 (3 of 3 patients). Right posteroparaseptal sites had negative delta waves in L2, L3, a VF, V3R to V9R, positive delta waves in V7 to V9, a superior QRS axis and an R greater than S in V1 (10 of 11 patients). Right free wall locations manifested negative delta waves in L3, a VR, V3R to V9R, positive delta waves in V7 to V9, a normal QRS axis and R wave transition in V3 to V5 with QS morphology since V3R to V9R (6 of 7 patients).(ABSTRACT TRUNCATED AT 250 WORDS)