Which of the following statements is true about the bundle of kent
Correct Answer: It is muscular or nodal pathway between the atria and ventricle in WPW syndrome
Description: * In the normal hea, atrioventricular conduction occurs across the specialized axis comprising the atrioventricular node (with its zones of transitional cells), the bundle of His, and the ventricular conduction pathways. This axis, for conduction to be normal, must be the solitary muscular connection between the atria and the ventricles. * Accessory pathways (APs) occur in 1 in 1500- 2000 people and are associated with a variety of arrhythmias including narrow-complex PSVT, wide- complex tachycardias, and, rarely, sudden death. * Most patients have structurally normal heas, but APs are associated with Ebstein's anomaly of the tricuspid valve and forms of hyperophic cardiomyopathy including PRKAG2 mutations, Danon's disease, and Fabry's disease. * WPW syndrome - accessory connections between aium and ventricle. This bypass tract may be atriofascicular, fascicular, intranodal, or nodoventricular (m/c is the atrioventricular pathway or Bundle of Kent). Conduction through this bundle can be either anterograde, retrograde, or both. Accessory pathways capable of only retrograde conduction - called as "concealed" * Accessory pathways capable of anterograde conduction - called as "manifest" * If the impulse from the sinus node conducts through the AP to the ventricle (antegrade) before the impulse conducts through the AV node and His bundle, then the ventricles are preexcited during sinus rhythm, and the ECG shows:- * A sho P-R interval (<0.12 s), * Slurred initial poion of the QRS (delta wave), and * Prolonged QRS duration produced by slow conduction through direct activation of ventricular myocardium over the AP Ref:- Harrison's Principles of Internal Medicine 20th edition; Pg num:- 1731
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