WPW Syndrome

A 13-years-male came to JIPMER Pondicherry hospital cardiology OPD  with chief complaints of palpitation on and off since last one year, history of syncope 3 episode over last 15 days along with atypical chest pain. ECHO of the patient was normal. ECG of the patient is shown below.

ECG 1(Click on the image to enlarge it)

Sinus rhythm at 90 beats per minute, left axis, PR interval 80 msec, Positive delta wave seen in leads 2,3,avf, negative delta wave seen  in lead V1, ST segment depression present in lead I,II, III, avF, V5,V6. So the ECG of the patient was suggestive of WPW syndrome with Right free wall pathway. 

In view of history of palpitation and syncope patient underwent Electrophysiological study which show Right free wall accessory pathway with preexcitation. Patient underwent successful ablation. 

Post ablation ECG is shown below.

ECG 2 (Click on the image to enlarge it)

ECG is showing Normal sinus rhythm at 75 beats per minute, normal axis, no pre-excitation seen. There is Deep T wave inversion in lead V1,V2 also there is T wave inversion seen in lead V3 suggestive of memory T wave post ablation therapy.

WPW Syndrome


Algorithm for  pathway localisation

Thank you.