Fasciculoventricular Pathway (FVP) vs WPW
Fasciculoventricular Pathway (FVP)
- His/fascicle → ventricle
- AV node still used
- Mild pre-excitation
EKG
- Slight ↓ PR
- Tiny delta
- QRS near normal
EP Study
- Fixed pre-excitation
- No change with pacing
- No reentry
Clinical
- Benign
- No ablation
Wolff-Parkinson-White (WPW)
- Atrium → ventricle (Bundle of Kent)
- Bypasses AV node
EKG
- Short PR
- Delta wave (slurred QRS upstroke)
- Wide QRS
EP
- Variable pre-excitation
- Forms AVRT
- Can conduct rapidly in AF
Clinical
- Arrhythmia risk (AVRT, AF → VF)
- Ablate if symptomatic/high-risk
Key Differences
| Feature | FVP | WPW |
|---|---|---|
| Pathway | His/fascicle → ventricle | Atrium → ventricle |
| AV node bypass | No | Yes |
| Pre-excitation | Mild, fixed | Marked, variable |
| Delta wave | Minimal | Prominent |
| QRS | Normal | Wide |
| Tachycardia | None | AVRT/AF |
| Significance | Benign | Potentially dangerous |
| Treatment | None | Ablation |