Accessory pathway, bundle of Kent and Wolff-Parkinson-White syndrome

Patient

Young man 21 years of age applying for a professional firefighter's position, referred for identification of an abnormal tracing; presented some episodes of tachycardia with sudden onset and end;

Trace

This electrocardiogram shows a typical pattern of ventricular pre-excitation: short PR interval (< 120 ms), delta wave at the beginning of the QRS, non-prolonged PJ delay, terminal QRS portion without abnormality;

Trace

This young patient underwent ablation of a left posteroseptal accessory pathway; the PR interval is normalized with disappearance of the delta wave (more pronounced slowing of the beginning of the QRS) and appearance of a physiological septal q wave in V5-V6; early repolarization pattern that could potentially normalize remotely to the ablation;

Exergue

The Wolff-Parkinson-White syndrome is defined by the combination of an atrioventricular pre-excitation (bundle of Kent) and paroxysmal supraventricular tachycardias. The diagnosis of atrioventricular pre-excitation in sinus rhythm is established on the association between a short PR interval, a wide QRS, a delta wave, a normal terminal QRS portion and frequent repolarization disorders.