Delta Wave Overview

The Delta wave is a slurred upstroke in the QRS complex often associated with a short PR interval. It is most commonly associated with pre-excitation syndrome such as WPW.

The characteristic ECG findings in the Wolff-Parkinson-White syndrome are:

  • Short PR interval (< 120ms)
  • Broad QRS (> 100ms)
  • A slurred upstroke to the QRS complex (the delta wave)

In 1930, Wolff, Parkinson, and White erroneously thought that the wide QRS complex was caused by a type of bundle-branch block. This was corrected in 1933 by Wolferth and Wood.

in 1944 Segers PM, Lequime J and Denolin proposed the symbol Δ to represent the triangle shape at the base of the upsloping QRS complex. They described the ‘… deformation of the PQ segment is the result of a supplementary electrical deflection that we propose to call Δ‘ . This became more commonly described as the ‘delta wave


ECG examples of Delta Waves
Delta wave

Negative delta waves (e.g. seen in lead aVR)

Further reading

References

ECG Library Basics

Advanced Reading

Online

Textbooks


LITFL Further Reading

ECG LIBRARY 700

ECG LIBRARY

Electrocardiogram

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

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