Orthodromic accessory pathway manifests on an ECG as a delta wave.

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Study for the EPU Electrophysiology Exam with comprehensive questions and explanations. Enhance your knowledge with flashcards and a variety of question formats to ensure you are prepared to excel!

Multiple Choice

Orthodromic accessory pathway manifests on an ECG as a delta wave.

Explanation:
Delta waves appear when an accessory pathway conducts antegradely from atria to ventricles, causing preexcitation and a shortened PR interval with a slurred initial QRS. In orthodromic AVRT, the ventricles are activated through the normal AV node antegradely, and the accessory pathway is used only retrogradely during tachycardia. So during normal rhythm there is no preexcitation via the pathway, and no delta wave is seen. Delta waves would be present only if the pathway conducted antegradely (preexcitation), as in WPW pattern or antidromic AVRT. Hence the statement is false.

Delta waves appear when an accessory pathway conducts antegradely from atria to ventricles, causing preexcitation and a shortened PR interval with a slurred initial QRS. In orthodromic AVRT, the ventricles are activated through the normal AV node antegradely, and the accessory pathway is used only retrogradely during tachycardia. So during normal rhythm there is no preexcitation via the pathway, and no delta wave is seen. Delta waves would be present only if the pathway conducted antegradely (preexcitation), as in WPW pattern or antidromic AVRT. Hence the statement is false.

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