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.

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 A case of wide complex tachycardia in wolff-parkinson-white syndrome

2019 ◽  
Vol 6 (4) ◽  
pp. 1
Author(s):  
Jonathan Lowenthal ◽  
Jack Xu ◽  
Eric Pagan ◽  
Richard Tangel ◽  
Daniel Schaer ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Presenting Symptoms ◽  
Wide Complex Tachycardia ◽  
Pr Interval ◽  
History Of ◽  
Ventricular Preexcitation ◽  
Posteroseptal Accessory Pathway ◽  
Wolff Parkinson White Syndrome

The manifestation of atrial flutter, particularly with 1:1 conduction, is rare in patients with ventricular preexcitation secondary to Wolff-Parkinson-White Syndrome (WPW). Very few cases have been reported in the literature. We present a 40-year old male with a history of untreated WPW who presented with severe chest pain and shortness of breath. He was found to have a rapid, regular, wide complex tachycardia. He underwent successful synchronized cardioversion, in which the patient converted tonormal sinus rhythm with classic WPW waveform characteristics, including a shortened PR interval and prolonged QRS complex with a slurred upstroke. Surprisingly, a subsequent electrophysiology study revealed atrial flutter, with bystander conduction of 1:1 atrial flutter being the most likely cause of the patient’s presenting symptoms, and a posteroseptal accessory pathway consistent with the diagnosis of WPW. While considerably rarer than ventricular tachycardia or AVRT, it is nevertheless important for clinicians to consider atrial flutter with 1:1 conduction as a potential diagnosis in patients with WPW presenting with wide complex 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.

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.

The prevalence of Wolff-Parkinson-White syndrome in newborns – results from a large general population study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Paerregaard ◽  
J Kock ◽  
C Pihl ◽  
A Pietersen ◽  
K.K Iversen ◽  
...  
Keyword(s):  
General Population ◽  
Population Study ◽  
Accessory Pathway ◽  
Structural Heart Disease ◽  
Control Group ◽  
Funding Source ◽  
General Population Study ◽  
Wpw Syndrome ◽  
Pr Interval ◽  
Qrs Duration

Abstract Background The accessory electrical pathway in Wolff-Parkinson-White (WPW) syndrome predisposes to tachycardia and may increase risk of sudden cardiac death. Studies investigating the prevalence of this condition in newborns are few. Purpose To describe the prevalence of WPW syndrome and assess the localization of the accessory pathway and associated structural heart disease in newborns from a large general population study. Methods Electrocardiograms (ECG's) and echocardiograms of 17.489 newborns (aged 0–30 days) from a large, prospective general population study were included. WPW cases were identified through manual evaluation of outliers in measurements of PR-interval, QRS-duration, QTcB interval and QRS axis. Newborns suspected for WPW syndrome were offered a secondary echocardiogram and ECG recording. Localization of the accessory pathway was assessed based on a QRS polarity algorithm. The control group consisted of 5,000 randomly selected newborns with a normal echocardiogram. Results Among the 17,489 ECG's we manually analyzed 5,166 and found 15 newborns (80% boys) with WPW syndrome (secondary confirmatory ECG's will be available at ESC 2020) consistent with prevalence of WPW syndrome of 0.1%. The median values of the PR-interval, QRS-duration and QTcB in cases and controls were 80 vs 98 ms, 74 vs 56 ms, and 449 vs 420 ms, respectively (all p<0.0001). The accessory electrical pathway was left-sided in 13 (87%) of the newborns. One newborn had moderate mitral regurgitation while all other newborns had structurally normal hearts and no cases of Ebstein's anomaly. Conclusion The prevalence of WPW syndrome in our cohort was 0.1%. The syndrome was more frequent in boys, and the accessory pathways were mainly left-sided. All but one of the affected newborns had structurally normal hearts. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): This work was supported by the Danish Children Heart Foundation, Snedkermester Sophus Jacobsen and wife Astrid Jacobsen's foundation (Grant 19-R112-A5248-26048), the Research Council at Herlev-Gentofte Hospital and Toyota-Fonden, Denmark.

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.

scholarly journals Intermittent delta waves mimicking inferior myocardial infarction

2014 ◽  
Vol 6 (1) ◽  
pp. 115-116
Author(s):  
Osman Can Yontar ◽  
Erhan Tenekecioglu ◽  
Kermal Karaagac ◽  
Ahmet Tutuncu
Keyword(s):  
Myocardial Infarction ◽  
Accessory Pathway ◽  
Inferior Myocardial Infarction ◽  
Medical Sciences ◽  
White Syndrome ◽  
Delta Waves ◽  
Pr Interval ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is recognized with existence of delta waves and a short PR interval on electrocardiogram. Delta waves may appear positive or negative deviated on different derivations corresponding to the location of accessory pathway. In some cases, delta waves mimic Q waves which should be distinguished by physicians. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10802 Asian Journal of Medical Sciences Vol.6(1) 2015 115-116

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.  

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