How can WPW tachycardia be distinguished from atrial tachycardia?

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Multiple Choice

How can WPW tachycardia be distinguished from atrial tachycardia?

Pre-excitation is the giveaway. In WPW, an accessory pathway pre-activates the ventricles, so the resting ECG shows a delta wave with a short PR interval. That pre-excitation is present regardless of the tachycardia mechanism, and the tachycardia itself can be narrow or wide depending on how the conduction happens. In contrast, atrial tachycardia starts in the atria and does not involve an antegradely conducting accessory pathway, so the baseline ECG typically lacks pre-excitation. Therefore, seeing pre-excitation at baseline points to WPW, while its absence points to atrial tachycardia.

Pre-excitation is the giveaway. In WPW, an accessory pathway pre-activates the ventricles, so the resting ECG shows a delta wave with a short PR interval. That pre-excitation is present regardless of the tachycardia mechanism, and the tachycardia itself can be narrow or wide depending on how the conduction happens. In contrast, atrial tachycardia starts in the atria and does not involve an antegradely conducting accessory pathway, so the baseline ECG typically lacks pre-excitation. Therefore, seeing pre-excitation at baseline points to WPW, while its absence points to atrial tachycardia.

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