The Algorithm of Milstein et al for Localizing Accessory Pathways


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Ventricular pre-excitation occurs when a part of the ventricular myocardium is activated by an impulse originating in the atrium which arrives via an accessory atrioventricular pathway before the impulse transmitted via the normal cardiac conduction system. The Wolff-Parkinson-White Syndrome is associated with ventricular pre-excitation. If the accessory pathway can be identified, then it can be ablated. The algorithm of Milstein et al uses a 12 lead electrocardiogram to localize the accessory pathway to one of 4 anatomic regions.

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