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Clinical significance of non-obstructive Q wave in Wolff-Parkinson-White syndrome |
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Abstract Objective To observe the lead of non-obstructive abnormal Q waves in the electrocardiogram of patients with Wolff-Parkinson-White syndrome, and analyze them according to the position of accessory pathways. Methods Forty-three patients whose ECG showed Wolf-Parkinson-White syndrome were selected, the abnormal Q waves and its location of occurrence, as well as related QRS axis were observed. The distribution of accessory pathways localization in the patients been treated by radiofrequency ablation therapy was analyzed, and the relationship between the abnormal Q wave, QRS axis and accessory pathways localization was studied. ResultsIn the 43 patients, twenty-eight cases(65%) showed abnormal Q waves, among which 22 cases exhibited abnormal Q waves in Ⅱ, Ⅲ and aVF leads with an the average QRS axis of -11°; seven cases showed abnormal Q waves in V1 leads with an average QRS axis of 16°; two cases showed abnormal Q waves in I and AVL leads with an average QRS axis of 82°; fifteen cases showed no abnormal Q wave with an average QRS axis of 26°. The accessory pathways localization of 14 patients were determined. The abnormal Q waves in Ⅱ, Ⅲ, aVF leads were all right pathways, with an average QRS axis of -22°. The V1 lead with abnormal Q waves was the right pathway, with an average QRS axis of 0°. I, aVL leads with abnormal Q wave was the leftfront wall with an average QRS axis of 97°. Those accessory pathways with no abnormal Q wave was the left pathways with an average QRS axis of 54°. There was statistical difference in the accuracy of accessory pathways localization according to the lead of abnormal Q wave (P<0.05). Conclusion Based on the appearance of the abnormal Q-wave and the presence of the different leads, we can do a preliminary location on the accessory pathways, and the electrical axis of QRS is different on the different accessory pathways.
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