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Orthodromic vs. Antidromic AVRT: The Loop Determines the QRS In AVRT, the circuit includes both the native conduction system and an accessory pathway (AP). The direction of impulse travel dictates the ECG morphology. 🔁 Orthodromic AVRT (Narrow QRS) • Down: AV node → His-Purkinje system (normal ventricular activation). • Back: Retrograde via the AP to the atria. • ECG: Narrow complex (unless aberrancy). ⚡ Antidromic AVRT (Wide QRS) • Down: AP directly into the ventricle (pre-excitation). • Back:
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