TH

13 STUDENTS SCIENTIFIC
SOCIETY CONFERECE

MAYANK NAYAK
CLC SYNDROME
3 rd YEAR
PR-INTERVAL
exists from starting of the P wave and starting of Q wave
marks AV nodal conduction
normal :- 120-200 msec (3-5 small squares)
P-R interval and heart rate are inversely proportional to each
other
HEART RATE
Lead II is used know as rythm strip
Ventricular rate is dependent on R-R interval
300/number of large square is heart rate.
if there is less than 3 large square then heart rate is more than
100 (onset tachyarrythemia)
if there is more than 5 large square there is heart rate is less
than 60 per minute (bradyarrethemia)
CLC SYNDROME (SHORT P-
R INTERVAL)
known as Clerk-Levy-Cristesco syndrome and also termed as
Syndrome of the shortened P-R interval (CLC syndrome)
occurs due to the presence of an accessory anomalous
pathway of conduction of electrical impulse (the bundle of
James) between the atria and the bundle of His. Sometimes
this syndrome is called LGL syndrome (Launa-Ganong-Levine).
NORMAL CONDUCTION
SYSTEM OF HEART
CONDUCTION SYSTEM IN
CLC
here extra bridge(James Bundle) is made which bypass AV
node and interpass it and current directly from SA node flow to
the Bundle of HIS. so here will be septal activation and will
show Q wave as it was absent in WPW syndrome.
and here current after this will flow to bundle branch and then
to purkinje fibres as it was not used in WPW syndrome
there is accessary pathway and which is faster due to no
resistance in this pathway there will be faster stimulation of the
ventricles and will result in the Tachycardia and palpitations so
CLC aka paroxysmal reciprocal atrioventricular nodal
tachycardia.
DIFFRENCE BETWEEN CLC
AND WPW
CLC SYNDROME WPW SYNDROME
PR interval shortening PR interval shortening
Q wave is present Q wave is absent here
Delta wave is absent here Delta wave is present here
James bundle Kent bundle
Pj interval is lowered Pj interval is normal
** The PJ interval represents the time
elapsed from the beginning of the P
wave to the end of the QRS complex
(J for junction between QRS and T
wave) in the ECG.
COMPLICATION’S
due to early conduction there will be early contraction of
partially filled ventricles
so CARDIAC OUTPUT will decrease
and patients physical performance will lower down
CLINICAL OBSERVATION
palpitation
syncopal attacks
family history of sudden cardiac death in siblling’s
ECG OBSERVATION

short PR intertval

Q wave will be present and QRS duration will be normal or less

PJ interval= PR+QRS= will be narrow

there will be no delta wave

Diagnosis

Accesary pathway mediated tachycardia

TRAETMENT RX....
so one thing is clear about treatment is
that you have to get tachycardia corrected
may be it in the form of surgery or drugs.
 TREATMENT RX.....
• in emergency cases:-
intravenous PROCANAMIDE
In most patients, procainamide hydrochloride in a daily dose of
50 mg/kg of body weight produces therapeutic plasma
concentrations. Three-hour dosage intervals are required to
prevent fluctuations of plasma level exceeding 50%. In urgent
situations, a parenteral priming dose should be given
• PREVENTION:-
• oral flecainide
• TREATMENT OF CHOICE:-

RADIO FREQUENCY ABLATION , which is burning of abnormal

pathway by laser.
THANK YOU FOR
ATTENTION