scholarly journals Wolff-Parkinson-White Syndrome Mimics a Conduction Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
S. Marrakchi ◽  
I. Kammoun ◽  
S. Kachboura
Keyword(s):  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Pacemaker Implantation ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Conduction Abnormality ◽  
Conduction Disorders ◽  
Associated Conditions ◽  
Wolff Parkinson White Syndrome ◽  
Cardiac Care Unit

Background. It is important to recognise Wolff-Parkinson-White (WPW) syndrome in electrocardiograms (ECG), as it may mimic ischaemic heart disease, ventricular hypertrophy, and bundle branch block. Recognising WPW syndrome allows for risk stratification, the identification of associated conditions, and the institution of appropriate management.Objective. The present case showed that electrophysiological study is indicated in patients with abnormal ECG and syncope.Case Report. A 40-year-old man with Wolff-Parkinson-White syndrome was presented to emergency with syncope. A baseline ECG was a complete right branch block and posterior left hemiblock. He was admitted to the cardiac care unit for pacemaker implantation. The atypical figure of complete right branch block and posterior left hemiblock was thought to be a “false positive” of conduction abnormality. But the long anterograde refractory period of the both accessory pathway and atrioventricular conduction may cause difficulty in diagnosing Wolff-Parkinson-White syndrome,Conclusion. A Wolff-Parkinson-White Syndrome may mimic a conduction disease. No reliable algorithm exists for making an ECG diagnosis of a preexcitation syndrome with conduction disorders. This can lead to diagnostic and therapeutic dilemmas in the context of syncope.

scholarly journals Sudden Cardiac Death: The Most Feared but Potentially Preventable Presentation of Wolff-Parkinson-White Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ana Rita Pereira ◽  
Alexandra Briosa ◽  
Rita Miranda ◽  
Sofia Sequeira Almeida ◽  
Luís Brandão ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Life Support ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Haemodynamic Instability ◽  
White Syndrome ◽  
Asymptomatic Patients ◽  
Wolff Parkinson White Syndrome

Background. Wolff-Parkinson-White syndrome is an uncommon cardiac disorder characterized by the presence of one or more accessory pathways that predispose patients to frequent episodes of arrhythmias. The prognosis is usually good, but there is a lifetime risk of malignant arrhythmias and sudden cardiac death. Case Summary. A 25-year-old male presented a witnessed out-of-hospital cardiac arrest with ventricular fibrillation rhythm. Due to rapid initiation of prehospital advanced life support, return of spontaneous circulation was observed. During the transport to the hospital, an irregular wide complex tachycardia suggestive of preexcited atrial fibrillation with haemodynamic instability was also observed and a synchronized shock was applied. Baseline 12-lead electrocardiogram was compatible with sinus rhythm and ventricular preexcitation pattern. After clinical stabilization, an electrophysiological study was performed confirming the presence of a left anterolateral accessory pathway with a short antegrade effective refractory period. Successful radiofrequency catheter ablation was achieved. Discussion. The reported clinical case recalls fundamental features of the Wolff-Parkinson-White syndrome and outlines the increasing evidence and importance of the invasive risk stratification and even catheter ablation in asymptomatic patients who suffer from this uncommon disease that may have a dramatic and fatal initial clinical manifestation.

scholarly journals Wolff–Parkinson–White syndrome: Implications for an anaesthesiologist

2017 ◽  
Vol 04 (01) ◽  
pp. 049-052 ◽  
Author(s):  
Vinaya Udaybhaskar ◽  
C. Sreemayee ◽  
Prasad Ingley
Keyword(s):  
General Anaesthesia ◽  
Electrical Conduction ◽  
Neurosurgical Procedure ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Conduction Abnormality ◽  
Cardiac Illness ◽  
Wolff Parkinson White Syndrome

AbstractWolff–Parkinson–White (WPW) syndrome is an electrical conduction abnormality of the heart that can induce potentially fatal arrhythmias at intermittent intervals. The induction and maintenance of general anaesthesia for a patient with WPW syndrome are risky due to the triggering capability of arrhythmias by various drugs and instrumentation. We hereby present the case of a 28-year-old male with previous cardiac illness, admitted for neurosurgical procedure, with drug-controlled WPW syndrome. The pre-operative optimisation, intraoperative scrutiny and vigil, along with readiness of standby medications and defibrillator made the ingress and egress from general anaesthesia uneventful. Thus, the potential dangers of WPW syndrome can be circumvented with watchful preparedness and meticulous monitoring.

scholarly journals Development and evaluation of 12-lead electrocardiogram in the left free wall of accessory pathway localization in patients with typical Wolff-Parkinson-White syndrome

2018 ◽  
Vol 5 (11) ◽  
pp. 2832-2840
Author(s):  
Si Dung Chu ◽  
Khanh Quoc Pham ◽  
Dong Van Tran
Keyword(s):  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
High Accuracy ◽  
Free Wall ◽  
Qrs Complex ◽  
White Syndrome ◽  
Delta Wave ◽  
Wpw Syndrome ◽  
Electrocardiogram Ecg ◽  
Wolff Parkinson White Syndrome

Objectives: This study was designed to characterize 12-lead electrocardiogram (ECG) for localization of the left free wall lateral accessory pathway (AP) in patients with typical Wolff-Parkinson-White (WPW) syndrome, to develop a new algorithm ECG for localizing APs, and to test the accuracy of the algorithm prospectively. Method: We studied 129 patients; 84 patients had typical WPW syndrome with single anterograde AP identified by successful radiofrequency catheter ablation (RFCA), and were enrolled to build a new ECG algorithm for localizing left free wall APs. Then, the algorithm was tested prospectively in 45 patients and compared with the location of APs successfully ablated by RFCA. Results: We found that the 12-lead ECG parameters in typical WPW syndrome, such as delta wave polarity in V1, R/S ratio in V1, transition of the QRS complex, and delta wave polarity in inferior, lead to diagnosis and localization of APs, with highest accuracy predicted from 74.5%-100%, and for development of a new ECG algorithm. From the 45 patients who were prospectively evaluated by the newly derived algorithm for the left free wall pathways, the sensitivity and specificity was high (from 75-100%). Conclusion: The 12-lead ECG parameters in typical WPW syndrome are closely related to left free wall AP localization and can be used to develop a new ECG algorithm by the parameters above. Moreover, the new ECG algorithm can predict the location of APs with high accuracy.  

scholarly journals The Clinical and Electrophysiological Features in Patients with Wolff- Parkinson- White Syndrome

2014 ◽  
Vol 10 (1) ◽  
pp. 17-19
Author(s):  
Murari Dhungana ◽  
Sujeeb Rajbhandari ◽  
Kunal Bikram Shaha ◽  
Mukunda Sharma ◽  
Man Bahadur KC
Keyword(s):  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Age Groups ◽  
White Syndrome ◽  
Conducting Pathway ◽  
Male Patients ◽  
Characteristic Features ◽  
Group 2 ◽  
Wolff Parkinson White Syndrome ◽  
Group 1

Background and Aims: Wolff-Parkinson-White Syndrome is a congenital anomaly with delta wave in electrocardiogram representing an accessory conducting pathway. The aim of the present study was to evaluate the characteristic features of patients who underwent electrophysiological study and radiofrequency ablation at Shahid Gangalal National Heart Centre. Methods: One hundred ninety eight patients with Wolff-Parkinson-White syndrome were divided in to three age groups; 1) 8 to 17, 2) 18 to 29 and 3) 30 to 70 years. The clinical, electrophysiological and therapeutic data of these patients were taken retrospectively from the hospital records. Result: A total of 10 (5%) of these patients were less than 18 years of age. There was no sex difference in group 1 and 2. There were significantly more male patients in group 3. There were fewer patients with left sided accessory pathway in group 1 compared to group 2 and 3 (p=0.024 and p=0.002, respectively). Conclusion: This study describes several different electrophysiological characteristics in patients with Wolff-Parkinson-White syndrome. The study showed that the detection of left side accessory pathway was less frequent in children and adolescents with Wolff-Parkinson- White syndrome as well as no gender preponderance in this age group. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 17-19 DOI: http://dx.doi.org/10.3126/njh.v10i1.9741

scholarly journals Accessory pathway analysis using a multimodal deep learning model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Nishimori ◽  
Kunihiko Kiuchi ◽  
Kunihiro Nishimura ◽  
Kengo Kusano ◽  
Akihiro Yoshida ◽  
...  
Keyword(s):  
Deep Learning ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Learning Model ◽  
X Rays ◽  
X Ray ◽  
Wpw Syndrome ◽  
Chest X Ray ◽  
Deep Learning Model ◽  
Ecg Data

AbstractCardiac accessory pathways (APs) in Wolff–Parkinson–White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.

scholarly journals Use of 3D mapping system for ablating an accessory pathway associated with coronary sinus diverticulum

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohammad Paymard ◽  
Marc W. Deyell ◽  
Santabhanu Chakrabarti ◽  
Zachary W. Laksman ◽  
Jacob Larsen ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Accessory Pathway ◽  
Three Dimensional ◽  
Radiofrequency Energy ◽  
Cardiac Mapping ◽  
Unsuccessful Attempt ◽  
White Syndrome ◽  
Mapping System ◽  
Coronary Sinus Diverticulum ◽  
Wolff Parkinson White Syndrome

Abstract Background This is a rare and challenging case of Wolff–Parkinson–White syndrome due to a posteroseptal accessory pathway located in the coronary sinus diverticulum. It is often difficult to precisely locate this type of accessory pathway, and the ablation procedure could be associated with collateral damage to the neighbouring coronary arteries. Case Presentation The patient was a 49-year-old female with Wolff–Parkinson–White syndrome who was referred for catheter ablation. She had had a previous unsuccessful attempt at ablation and had remained symptomatic despite drug therapy. The pre-procedural cardiac computed tomography scan revealed the presence of a diverticulum in the proximal coronary sinus. Using an advanced three-dimensional cardiac mapping system, the electroanatomic map of the diverticulum was created. The accessory pathway potential was identified within the diverticulum preceding the ventricular insertion. The accessory pathway was then successfully ablated using radiofrequency energy. Conclusion We have demonstrated that the advanced three-dimensional cardiac mapping system plays a very important role in guiding clinicians in order to precisely locate and safely ablate this type of challenging accessory pathway.

MODELING OF WOLFF–PARKINSON–WHITE SYNDROME

2003 ◽  
Vol 13 (12) ◽  
pp. 3827-3834
Author(s):  
ROBERT HINCH
Keyword(s):  
Asymptotic Analysis ◽  
Ion Channel ◽  
Sodium Channel ◽  
Channel Model ◽  
Accessory Pathway ◽  
Simplified Model ◽  
Channel Kinetics ◽  
White Syndrome ◽  
Channel Density ◽  
Wolff Parkinson White Syndrome

Wolff–Parkinson–White syndrome is a disease where an arrhythmia is caused by the ventricles being electrically excited by an additional accessory pathway that links the atria to the ventricles. The spread of the activation wave from this pathway to the ventricles is modeled using a simplified model of Hodgkin–Huxley sodium channel kinetics, in a two ion-channel model. The model is investigated both analytically (using an asymptotic analysis) and numerically, and both methods are shown to give the same result. It is found that for a given width of the accessory pathway, there is a critical sodium channel density needed for the activation wave to spread from the pathway to the tissue. This result provides an explanation for the success of class-I anti-arrhythmic drugs in treating Wolff–Parkinson–White syndrome.

Sign in / Sign up

Export Citation Format

Share Document