This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.
This is a rhythm strip from a patient with ventricular pre-excitation. Of interest is that the pre-excitation is manifested by premature atrial beats which cause four pre-excited ventricular complex (labeled V). This suggests that the refractory period of the A/V node is longer than that of the accessory pathway.