scholarly journals Clinical and Demographic Characteristics of WPW Syndrome Attending Arrhythmia Clinic of NICVD

2014 ◽  
Vol 41 (2) ◽  
pp. 50-53
Author(s):  
MM Rahman ◽  
MMR Khan ◽  
N Kamal ◽  
AK Shamim ◽  
MS Akter ◽  
...  
Keyword(s):  
Antiarrhythmic Drugs ◽  
Demographic Data ◽  
Accessory Pathway ◽  
Atrioventricular Reentrant Tachycardia ◽  
Wpw Syndrome ◽  
Ventricular Response ◽  
Life Threatening ◽  
Study Population ◽  
Left And Right ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is a disorder characterized by presence of an accessory pathway which predisposes patients to tachyarrhythmias and sudden death. Among patients with WPW syndrome, atrioventricular reentrant tachycardia (AVRT) is the most common arrhythmia, accounting for 95% of re-entrant tachycardias. It has been estimated that one-third of patients with WPW syndrome have atrial fibrillation (AF). AF is a potentially life-threatening arrhythmia. If an accessory pathway has a short anterograde refractory period, then rapid repetitive conduction to the ventricles during AF can result in a rapid ventricular response with subsequent degeneration to ventricular fibrillation (VF). The study population included a total of 255 patients in whom 175 (68.62%) were men and 80 (31.38%) were women. Demographic data and clinical characteristics are depicted in Table 1. Left and right WPW syndrome were existing in 70.59% and 29.41% of patients respectively. Documented narrow QRS SVT was present in 96.86%, broad QRS SVT was in 2.75% and AF was in 3.14% of patients. Antiarrhythmic drugs most frequently used were Digitalis, Metoprolol, Sotalol, Amiodarone and Verapamil DOI: http://dx.doi.org/10.3329/bmj.v41i2.18809 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 50-53

scholarly journals Pre-excitation pattern associated with accessory pathway related tachycardia: Case report

2010 ◽  
Vol 138 (9-10) ◽  
pp. 639-642
Author(s):  
Mirko Burazor ◽  
Ivana Burazor ◽  
Nebojsa Mujovic
Keyword(s):  
Ventricular Tachycardia ◽  
Diagnostic Tests ◽  
Accessory Pathway ◽  
Accurate Assessment ◽  
Wpw Syndrome ◽  
Conduction Pathway ◽  
Difficulty Breathing ◽  
Life Threatening ◽  
Mapping Techniques ◽  
Excitation Pattern

Introduction. Pre-excitation is based on an accessory conduction pathway between the atrium and ventricle. The term Wolff- Parkinson-White (WPW) syndrome is used for patients with the pre-excitation/WPW pattern associated with AP-related tachycardia. Case Outline. We present a 52-year-old man with severe palpitation, fatigue, lightheadedness and difficulty breathing. The initial ECG showed tachyarrhythmia with heart rate between 240 and 300/min. He was treated with antiarrhythmics (Digitalis, Verapamil, Lidocaine) with no response. Then, the patient was treated with electrical cardioversion and was referred to our Clinic for further evaluation with the diagnosis: ?Ventricular tachycardia?. During in-hospital stay, the previously undiagnosed WPW pattern had been seen. Additional diagnostic tests confirmed permanent pre-excitacion pattern (ECG Holter recording, exercises test). The patient was referred to an electrophysiologist for further evaluation. Mapping techniques provided an accurate assessment of the position of the accessory pathway which was left lateral. The elimination of the accessory pathway by radiofrequent catheter ablation is highly effective in termination and elimination of tacchyarrhythmias. Conclusion. Symptomatic, life-threatening arrhythmia, first considered as ventricular tachycardia, reflected atrial fibrillation with ventricular pre-excitation over an accessory pathway in a patient with previously undiagnosed WPW syndrome.

Wolff-Parkinson-White Syndrome

1992 ◽  
Vol 3 (1) ◽  
pp. 180-189 ◽  
Author(s):  
Joanne Hughes Morscher
Keyword(s):  
Sudden Cardiac Arrest ◽  
Cardiac Conduction ◽  
Treatment Modalities ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Diagnostic Modalities ◽  
Supraventricular Tachycardias ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a cardiac conduction disorder that presents with potentially life-threatening consequences. Wolff-Parkinson-White syndrome-induced dysrhythmias account for 20% of all supraventricular tachycardias that occur in the general population. Clinical presentations range from no symptoms to a sudden cardiac arrest. The risk of sudden death is always present with WPW syndrome, and it is the motivating force in the evaluation and treatment of this syndrome. Current diagnostic modalities are accurate in identifying patients with WPW syndrome, but lack the sensitivity to predict sudden cardiac death. This article reviews the history of WPW syndrome, as well as its general characteristics, diagnostic criteria, treatment modalities, and nursing implications

WOLFF-PARKINSON-WHITE SYNDROME

2020 ◽  
pp. 34-38
Author(s):  
Pedada Syam Prashanth Pedada Syam Prashanth ◽  
Allamsetty Jyotsna Allamsetty Jyotsna ◽  
Modukuri.Sravya Modukuri.Sravya ◽  
Swathi Priya.Vana Swathi Priya.Vana ◽  
Tushara Bammidi Tushara Bammidi ◽  
...  
Keyword(s):  
Accessory Pathway ◽  
Young Patients ◽  
Av Node ◽  
Bundle Branch Block ◽  
Wpw Syndrome ◽  
Pr Interval ◽  
Cardiac Ventricles ◽  
Seminal Article ◽  
Electrical Connections ◽  
Wolff Parkinson White Syndrome

WPW syndrome is a congenital heart disease that is characterized by the presence of abnormal electrical connections between the atria and ventricles of the heart. In 1930, Louis Wolff, Sir John Parkinson, and Paul Dudley white published a seminal article describing the 11 young patients who suffered from attacks of tachycardia associated with an electrocardiographic pattern of ‘bundle branch block’ with a short PR interval. So from there onwards, it is called Wolff Parkinson white [WPW] syndrome. The normal conduction of the AV node occurs slowly than the accessory pathway conduction. Preexcitation is a process that the cardiac ventricles are activated earlier than the impulse of the AV node which leads to the shorter PR interval and formation of a delta wave. The supraventricular tachycardia associated with WPW syndrome is called AV reentrant or reciprocating tachycardia (AVRT).WPW syndrome is that there is an accessory pathway between the atrium and ventricles which cause rapid heartbeat or tachycardia.

scholarly journals ID: 1081 Development and validation of surface electrocardiogram in the septal accessory pathway localization in typical Wolff-Parkinson-White syndrome

2017 ◽  
Vol 4 (S) ◽  
pp. 167
Author(s):  
Si Dung Chu ◽  
Khanh Quoc Pham ◽  
Dong Van Tran
Keyword(s):  
Accessory Pathway ◽  
High Sensitivity ◽  
High Accuracy ◽  
Qrs Complex ◽  
Delta Wave ◽  
Wpw Syndrome ◽  
Development And Validation ◽  
Electrocardiogram Ecg ◽  
Surface Electrocardiogram ◽  
Wolff Parkinson White Syndrome

Objectives: This study was designed characteristics of surface electrocardiogram (ECG) for the localization of septal accessory pathway (AP) in the typical Wolff-Parkinson-White (WPW) syndrome to develop a new algorithm ECG for the septal AP localization, and to test the accuracy of the algorithm prospectively.  Subject and Methods: We studied 106 patients, in 65 patients with typical WPW syndrome have a single anterograde with the localization of Aps identified by successful radiofrequency catheter ablation (RCFA) to develop a new ECG algorithm for the septal AP localization. Then this algorithm was tested propectively in 41 patients were compared with the location of AP’s successful ablation by RCFA (gold standard).  Results: We found that the 12 lead ECG parameters in 65 patients with typical WPW syndrome such as the transition of the QRS complex, delta wave polarity in V1 lead, delta wave polarity in at least 2/3 inferior leads and morphology QRS was “QRS pattern’’ in inferior leads in diagnosis for the localization of septal APs with hight accuracy predicted from 83.3% to 100%, and for development of a new ECG algorithm. Then the following 41 patients were prospectively evaluated by the new derived algorithm for the septal pathways with high sensitivity and specificity from 84.6% to 100%.  Conclusion: 12-lead ECG parameters in typical WPW syndrome closely related to the septal AP localization, in order to develop the new ECG algorithm by parameters as above; and can be used to a new septal ECG algorithm in predicted the location APs with high accuracy predicted

scholarly journals Development and evaluation of surface electrocardiogram in the septal accessory pathway localization in typical Wolff-Parkinson-White syndrome

2018 ◽  
Vol 5 (9) ◽  
pp. 2680-2687
Author(s):  
Si Dung Chu ◽  
Khanh Quoc Pham ◽  
Dong Van Tran
Keyword(s):  
Accessory Pathway ◽  
High Sensitivity ◽  
High Accuracy ◽  
Strongly Correlated ◽  
Qrs Complex ◽  
Delta Wave ◽  
Wpw Syndrome ◽  
Electrocardiogram Ecg ◽  
Surface Electrocardiogram ◽  
Wolff Parkinson White Syndrome

Objectives: This study was designed to characterize the surface electrocardiogram (ECG) of the typical Wolff-Parkinson-White (WPW) syndrome to develop a new algorithm ECG to localize the septal accessory pathways (APs) and to prospectively test the accuracy of the algorithm. Methods: We studied 106 patients, in which 65 patients with typical WPW syndrome who had a single antero-grade with the localization of APs identified by successful radiofrequency catheter ablation (RFCA) to develop a new ECG algorithm for the septal AP localization. Then, this algorithm was tested prospectively in 41 patients to compare to the localization of APs by successful ablation by RFCA (gold standard). Results: In 65 patients with typical WPW syndrome, we found that the 12-lead ECG parameters such as the transition of the QRS complex, delta wave polarity in V1 lead, delta wave polarity in at least 2/3 inferior leads and ``QRS pattern'' in inferior leads can predict the localization of septal APs with the accuracy ranging from 83.3% to 100%. Then, 41 patients were prospectively evaluated by the new derived algorithm to localize the septal APs with high sensitivity and specificity from 84.6% to 100%. Conclusion: 12-lead ECG parameters in typical WPW syndrome are strongly correlated to the septal AP localization, which can be used to develop a new ECG algorithm to localize septal APs with high accuracy.

Diagnosis and management of arrhythmias associated with Wolff-Parkinson-White syndrome

1994 ◽  
Vol 14 (3) ◽  
pp. 30-39 ◽  
Author(s):  
MB Conover
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Treatment ◽  
Accessory Pathway ◽  
P Wave ◽  
Av Node ◽  
Wpw Syndrome ◽  
Reentry Tachycardia ◽  
Fast Pathway ◽  
Wolff Parkinson White Syndrome

Because of the emergency nature of the arrhythmias associated with WPW syndrome, nurses are often called upon for diagnosis and intervention in critical settings. In such cases the nurse's understanding of mechanisms, ECG recognition, and emergency treatment guarantees the patient the best possible outcome, not only in the critical setting, but in the long term as well. The most common arrhythmias of WPW syndrome are PSVT and atrial fibrillation. In PSVT a differential diagnosis is made on the ECG between (1) CMT using the AV node anterogradely and an accessory pathway retrogradely and (2) AV nodal reentry tachycardia. Helpful clues are location of the P' wave, presence of QRS alternans, the initiating P'R interval, and presence of aberrancy. Atrial fibrillation with an accessory pathway has the morphology of VT but is differentiated because the rhythm is irregular and the rate is more than 200 beats per minute. Emergency treatment consists of blocking the accessory pathway with procainamide. Emergency treatment for both types of PSVT consists of breaking the reentry circuit at the AV node (eg, vagal maneuver, adenosine, or verapamil). Procainamide can also be used to block the retrograde fast pathway in the AV node and to terminate CMT by blocking the accessory pathway. Symptomatic patients with accessory pathways are referred for evaluation and possible radio-frequency ablation.

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 Wolff-Parkinson-White syndrome presenting as atrial fibrillation with broad-QRS complexes

1970 ◽  
Vol 6 (3) ◽  
pp. 52-57 ◽  
Author(s):  
MP Gautam ◽  
L Thapa ◽  
S Gautam
Keyword(s):  
Atrial Fibrillation ◽  
Early Recognition ◽  
Accessory Pathway ◽  
Medical Sciences ◽  
Wpw Syndrome ◽  
Paroxysmal Tachycardia ◽  
Uncommon Presentation ◽  
Ventricular Response ◽  
Rapid Restoration ◽  
Dc Cardioversion

The Wolff-Parkinson-White (WPW) syndrome is the commonest form of ventricular pre-excitation and is characterised by the presence of an accessory pathway between atria and ventricles. The term WPW syndrome is applied to patients with both pre-excitation on the ECG and paroxysmal tachycardia. Usually the conducting properties of bypass tracts and the AV node differ, the ventricular response during atrial flutter or fibrillation may be unusually rapid and may cause ventricular fibrillation. Atrial fibrillation (AF) is not an uncommon presentation in emergency department. Moreover, AF associated with WPW syndrome as an underlying condition is also not a rare occurrence; it is seen in 20-25% of WPW Syndrome. Recognition of this condition is very crucial in terms of emergency management. Its early recognition and initial treatment allows rapid restoration to sinus rhythm. Acute management of WPW syndrome with atrial fibrillation with hypotension is DC cardioversion. In haemodynamically stable patients, the drugs of choice are Amiodarone and class Ic anti- arrhythmic agents. Key words: Paroxysmal tachycardias; pre-excitation; tachycardia. DOI: 10.3126/jcmsn.v6i3.4078Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.52-57

scholarly journals ID: 1043 Study value of 12-lead ECG for the left free wall of accessory pathways diagnosing in patients with typical Wolff-Parkinson-White Syndrome

2017 ◽  
Vol 4 (S) ◽  
pp. 122
Author(s):  
Chu Dung Si ◽  
Pham Quoc Khanh ◽  
Tran Van Dong
Keyword(s):  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
High Sensitivity ◽  
High Accuracy ◽  
Free Wall ◽  
Qrs Complex ◽  
Delta Wave ◽  
Wpw Syndrome ◽  
Electrocardiogram Ecg ◽  
Wolff Parkinson White Syndrome

Objectives: This study was designed characteristics of 12-lead Electrocardiogram (ECG) for the left free wall lateral of accessory pathway (AP) localization in the typical WPW syndrome to develop a new algorithm ECG for localizing APs, and to test the accuracy of the algorithm prospectively. Methods: We studied 129 patients, in 84 patients with typical WPW syndrome have a single anterograde with the localization of APs identified by successful radiofrequency catheter ablation (RCFA) to develop a new ECG algorithm for the left free wall of localizing APs. Then this algorithm was tested prospectively in 45 patients were compared with the location of AP’s successful ablation by RCFA.  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, the transition of the QRS complex, delta wave polarity in inferior leads in diagnosis for the localization of APs by with high accuracy predicted from 74,5% to 100%, and for development of a new ECG algorithm. Then the following 45 patients were prospectively evaluated by the new derived algorithm for the left free wall pathways with high sensitivity and specificity from 75% to 100%. Conclusion: 12-lead ECG parameters in typical WPW syndrome closely related to left free wall of APs localization, in order to develop the new ECG algorithm by parameters as above; and can be used to a new ECG algorithm in predicting the location APs with high accuracy.

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