All are ECG findings in Wolf Parkinson’s white syndrome, except :
**Core Concept**
Wolf-Parkinson-White (WPW) syndrome is a rare cardiac disorder characterized by the presence of an accessory electrical pathway between the atria and ventricles, leading to abnormal heart rhythms. This aberrant pathway can cause a delay in the electrical impulse, resulting in a prolonged PR interval and a short QRS complex.
**Why the Correct Answer is Right**
WPW syndrome is typically associated with the following ECG findings:
* Short PR interval (< 120 ms): The accessory pathway allows the electrical impulse to bypass the normal atrioventricular (AV) node, resulting in a shorter time between the onset of the P wave and the QRS complex.
* Wide QRS complex: The electrical impulse travels down the accessory pathway, causing a faster and more forceful contraction of the ventricles, which can lead to a wider QRS complex.
* Delta wave: A slurred upstroke at the beginning of the QRS complex, resulting from the fusion of the normal and abnormal electrical impulses.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because WPW syndrome is not typically associated with a long QT interval. WPW syndrome is primarily related to the accessory pathway affecting the PR interval and QRS complex.
* **Option B:** This option is incorrect because WPW syndrome is not typically associated with a normal ECG. The presence of an accessory pathway leads to characteristic ECG changes, such as a short PR interval and a wide QRS complex.
* **Option C:** This option is incorrect because WPW syndrome is not typically associated with a tall R wave in lead V1. While WPW syndrome can cause various ECG changes, this specific finding is not characteristic of the condition.
**Clinical Pearl / High-Yield Fact**
WPW syndrome is a potentially life-threatening condition that can cause tachyarrhythmias, such as atrial fibrillation or atrial flutter. It is essential to recognize the characteristic ECG findings and diagnose WPW syndrome promptly to prevent complications.
**Correct Answer:**
A.