In antedromic AVRT, the impulse travels down the accessory pathway and up the AV node. Which option describes this pattern?

• A. Down The AV Node And Up The Pathway
• B. Down The Accessory Pathway And Up The AV Node
• C. Only Within The Atria
• D. From Ventricle To Atrium Via The Pathway

Answer: (B)

Antidromic AVRT features antegrade conduction through the accessory pathway and retrograde conduction through the AV node. In this pattern, the impulse travels down the accessory pathway to activate the ventricles first, then travels up through the AV node to re-enter the atria. This results in ventricular activation occurring via the accessory pathway, producing a wide QRS tachycardia, while the atria are driven retrogradely via the AV node. By contrast, orthodromic AVRT uses the AV node for antegrade conduction and the accessory pathway for retrograde conduction, which typically yields a narrow QRS tachycardia. The described pattern—down the accessory pathway and up the AV node—best fits antidromic AVRT.