Lown-Ganong-Levine syndrome

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  • Poorly understood pre-excitation condition
  • Atrioventricular re-entrant tachycardia (AVRT) due to James fibers
    • Bundle of James accessory pathway creates atrio-hisian bypass tract
      • Convincing existence of the James accessory pathway has not been conclusively demonstrated

Clinical Features

Differential Diagnosis

Narrow-complex tachycardia



  • ECG
    • Short PR interval
    • Normal QRS
    • No delta wave
    • May have ventricular premature complexes
  • May appear similar to:
    • WPW
    • AV junctional rhythm


  • Vagal manoeuvres may terminate episodes of SVT
  • Counsel to avoid alcohol, coffee, and other stimulants
  • Patients with demonstrated accessory pathways on electrophysiological study may benefit from ablation


  • Home with cardiology follow up
  • Consider referral for Holter monitor, echo to rule out structural disease, and electrophysiologic studies

See Also