gs1-128 UTRAN Transmission Infrastructure Planning and Optimisation in .NET

Implementation data matrix barcodes in .NET UTRAN Transmission Infrastructure Planning and Optimisation

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complex are not separated by an isoelectric PR segment. The QRS complex in lead V1 is predominantly negative, because of early right-to-left depolarization of the right ventricle due to the right-sided accessory pathway. Patients with a left-sided accessory pathway will have a different ECG pattern. In this case a short isoelectric PR interval may be observed, since the AV node will be depolarized before the accessory pathway (think of it getting a head start ). However, since the AV node has slow conduction properties, depolarization via the accessory pathway still beats the AV node and a delta wave and an abnormal QRS complex are still seen. In this case left ventricular activation occurs before right ventricular activation, and the general shape of the QRS complex will resemble a right bundle branch block pattern with a prominent positive QRS in V1. Since the delta wave represents ventricular depolarization via the accessory pathway, careful analysis of the delta wave can provide further clues for accessory pathway localization. If the accessory pathway is located at the lateral wall of the mitral annulus, the delta wave will be negative in I and aVL due to ventricular depolarization traveling away from this area (Fig. 9.3). If the accessory pathway is located more inferiorly and closer to the septum (Fig. 9.4) the delta waves will be negative in the inferior leads (II, III, and aVF). In patients with a concealed accessory pathway a normal PR interval will be present and a delta wave will not be observed since there is no anterograde conduction over the accessory pathway. It has been suggested that some pathways are concealed because they are thinner and the voltage generated by accessory pathway depolarization is not suf cient to depolarize adjacent ventricular tissue. However, since the atria are thinner, retrograde depolarization of atrial tissue can still occur, and for this reason these patients still develop supraventricular tachycardia.
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