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(Circulation. 2008;118:1767.)
© 2008 American Heart Association, Inc.

Images in Cardiovascular Medicine

Classic Holter Manifestation of Wolff-Parkinson-White Pattern

Xiushui Ren, MD; Steven L. Blumlein, MD

From the Division of Cardiology, California Pacific Medical Center, San Francisco, Calif (X.R., S.L.B.).

Correspondence to Xiushui Ren, MD, Division of Cardiology, California Pacific Medical Center, 2333 Buchanan St, San Francisco, CA 94115. E-mail Xiushui@yahoo.com

An extract of the first 100% of the full text is provided, because this article has no abstract.

A 27-year-old man without significant past medical history presented to the cardiology outpatient clinic for intermittent palpitations. A 24-hour Holter revealed baseline sinus rhythm with delta waves (Figure, arrows). A premature ventricular beat initiates a run of narrow complex tachycardia (Figure, arrowheads), with loss of delta wave and appearance of inverted P waves (P) indicative of retrograde atrial activation. This series of events is diagnostic of the Wolff-Parkinson-White pattern (Figure).

View larger version (54K):   Figure. Electrocardiographic strip showing baseline sinus rhythm with delta waves (arrows), premature ventricular beat (PVB), and initiation of orthodromic tachycardia with loss of delta waves (arrowheads).

Disclosures

None.