Left Axis Deviation in WPW Conduction

Report:

Sinus arrhythmia 58 – 100/min

Left axis deviation –40o

Wolff-Parkinson-White conduction, type ‘B’

Comment:

Either type ‘A’ or ‘B’ can produce inferior Q waves, usually QS complexes; ‘A’, of course, can mimic posterior infarcts while ‘B’ may resemble anterior infarcts.

The PR interval may be normal in WPW conduction and indeed tends to get longer with age, but in most cases this is an illusion – either terminal P wave or the initial δ wave is isoelectric. In this example it is quite short, 0.10”. There is no PR segment: the QRS (δ wave) onset is at the end of the P wave.

The narrow-complex tachycardia in the country hospital was almost certainly an SVT.

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