The presence of a Q wave in lead V5 excludes manifest preexcitation

Behzad B. Pavri, Robert Coyne, Dusan Z. Kocovic

Research output: Contribution to journalArticle

Abstract

Background: The degree of preexcitation in patients with the Wolff- Parkinson-White syndrome may vary depending on autonomic tone, heart rate, pathway location, and atrioventricular node conduction. When subtle, preexcitation may be difficult to detect with a 12-lead electrocardiogram (ECG). Furthermore, the pattern of preexcitation may be mimicked in patients with QRS widening and rapid atrioventricular node conduction. Methods: We studied 50 patients with manifest accessory pathways who underwent electrophysiological study and pathway ablation. Pre- and postablation ECGs for the presence or absence of a Q wave in leads V5 and V6 were studied. ECGs from an additional 19 patients were used to validate the observations. Results: We found that no patient with preexcitation had a Q wave in lead V5 and only 1 of 50 patients had a Q wave in V6. This was a reproducible finding in the 26 patients with multiple ECGs obtained on separate days. The results were validated in an additional 19 patients none of whom had a Q wave in V5, and 1 had a Q wave in V6. Conclusions: The presence of a Q wave in lead V5 reliably excludes manifest preexcitation.

Original languageEnglish (US)
Pages (from-to)200-203
Number of pages4
JournalAnnals of Noninvasive Electrocardiology
Volume4
Issue number2
DOIs
StatePublished - Jul 13 1999
Externally publishedYes

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Electrocardiography
Atrioventricular Node
Wolff-Parkinson-White Syndrome
Lead
Heart Rate

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "The presence of a Q wave in lead V5 excludes manifest preexcitation",
abstract = "Background: The degree of preexcitation in patients with the Wolff- Parkinson-White syndrome may vary depending on autonomic tone, heart rate, pathway location, and atrioventricular node conduction. When subtle, preexcitation may be difficult to detect with a 12-lead electrocardiogram (ECG). Furthermore, the pattern of preexcitation may be mimicked in patients with QRS widening and rapid atrioventricular node conduction. Methods: We studied 50 patients with manifest accessory pathways who underwent electrophysiological study and pathway ablation. Pre- and postablation ECGs for the presence or absence of a Q wave in leads V5 and V6 were studied. ECGs from an additional 19 patients were used to validate the observations. Results: We found that no patient with preexcitation had a Q wave in lead V5 and only 1 of 50 patients had a Q wave in V6. This was a reproducible finding in the 26 patients with multiple ECGs obtained on separate days. The results were validated in an additional 19 patients none of whom had a Q wave in V5, and 1 had a Q wave in V6. Conclusions: The presence of a Q wave in lead V5 reliably excludes manifest preexcitation.",
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The presence of a Q wave in lead V5 excludes manifest preexcitation. / Pavri, Behzad B.; Coyne, Robert; Kocovic, Dusan Z.

In: Annals of Noninvasive Electrocardiology, Vol. 4, No. 2, 13.07.1999, p. 200-203.

Research output: Contribution to journalArticle

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