Electrocardiogram of an 18 year-old lad with recurrent palpitations during hockey and baseball games.

Rate 62/min
PR 0.08 sec
QRS 0.14 sec
QT 0.42 sec
QTc 0.429 sec
QRS axis +100º

Interpretation: Abnormal ECG. Sinus rhythm. Short PR interval. Delta wave. Wide QRS complex and secondary ST-T changes. Pre-excitation with left ventricular lateral accessory pathway.

For localization of accessory pathway refer to the ECG from March 2003.

Despite apparent voltage criteria for LVH, this patient does not have LVH nor RVH – normal LV wall thickness and LV mass (85 g/m², normal - male <134, female < 110) on an echocardiogram. Voltage criteria do not apply below the age of 40.

For voltage criteria for LVH refer to the ECG from January 2003.

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