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In Wolff-Parkinson-White Syndrome (WPW), presence of accessory pathways causes various tachyarrhythmias that lead to different symptoms and clinical conditions in patients. Atrial fibrillation is observed in about 20-30% of this group of patients. Life threatening malignant ventricular arrhythmias and sudden cardiac deaths are observed in patients...
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Wolff-Parkinson-White (WPW) syndrome is a conduction disturbance characterized by the presence of an accessory pathway between the atria and the ventricles. The accessory pathway predisposes patients to tachyarrhythmias and sudden cardiac death. Among patients with WPW syndrome, atrioventricular reentrant tachycardia (AVRT) is the most common arrhy...
Citations
... WPW is one of the most common congenital cardiac abnormalities among the ventricular pre-excitation syndromes, with a prevalence of 0.9% to 3% in the general population. 1 The pre-excitation syndrome is diagnosed by a surface electrocardiography (ECG) in sinus rhythm, which shows a typical pattern of a short PR interval (<0.12 s in adults) and a widening of QRS complex, associated with a delta wave. 2 Patients with WPW syndrome may present with palpitations, presyncope, syncope, or sudden cardiac death (SCD). The most effective treatment in symptomatic patients is radiofrequency catheter ablation (RFCA); the success rate is reasonably high. ...
Objective: We sought to examine the diagnostic accuracy of tissue Doppler imaging (TDI) for the localization of the accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome. Material and Methods: We prospectively studied 35 patients with evidence of pre-excitation on electrocardiography. Patients were categorized into three groups according to the site of the AP: left ventricular free wall; septal; and right ventricular free wall. The recordings obtained using TDI from the lateral mitral annulus, septal annulus, and lateral tricuspid annulus were respectively compared with the electrophysiological study (EPS) results for the location of the AP. Electromechanical interval (p-Sm) was defined as the time difference between the onset of the p wave and the onset of regional myocardial contraction (Sm) on echocardiography. Results: In patients with left free access in EPS, electromechanical interval (pre-p-Sm) in the lateral mitral annulus was significantly shorter in the other two regions (septal annulus, and lateral tricuspid annulus) in TDI before treatment (p=0.0001). In patients with septal AP and right free AP detected at EPS, the pre-p-Sm interval was shorter, respectively, at the septal annulus and lateral tricuspid annulus, but was not statistically significant, due to the small numbers of patients in both regions. Conclusion: The p-Sm interval in TDI before the ablation procedure, specifically in patients having a left free AP, was found to be short due to early stimulus. This was especially detected without using a free electrocardiogram (ECG) algorithm. The prediction of AP in TDI may play an important role in planning and performing the radiofrequency catheter ablation (RFCA).
... Atrial fibrillation or flutter may occur in patients with an accessory pathway, which is potentially life-threatening, because of the tendency to convert into ventricular fibrillation. [8][9][10][11][12][13] Atrial fibrillation occurs in 1.6-18% of patients with WPW. [8,[14][15][16][17][18][19] Considering that the prevalence of WPW syndrome in the general population is 0.1-0.3%, it can be assumed that AF with the underlying pre-excitation syndrome occurs in 1.6 to 54 of 100 000 inhabitants per ...
Background: Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW)
syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The
aim of this study was to assess whether the emergency medical team members are able to
diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass
tract in WPW syndrome.
Methods: The study group consisted of 316 participants attending a national congress of
emergency medicine. A total of 196 questionnaires regarding recognition and management of
cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a
young hemodynamically stable man who had a 12-lead electrocardiogram performed in the
past with signs of pre-excitation, and who presented to the emergency team with an irregular
broad QRS-complex tachycardia.
... WPW is one of the most common congenital cardiac abnormalities among the ventricular pre-excitation syndromes, with a prevalence of 0.9% to 3% in the general population [16]. In general, WPW is characterized by the presence of an abnormal accessory electrical conduction pathway which may produce ventricular pre-excitation and paroxysmal reentrant tachycardia [17]. In particular, frequent tachycardias may also promote electrical remodeling and an increased atrial vulnerability to AF, which has been shown to more frequently induce sustained episodes of AF [18,19]. ...
... In particular, frequent tachycardias may also promote electrical remodeling and an increased atrial vulnerability to AF, which has been shown to more frequently induce sustained episodes of AF [18,19]. To date, approximately one third of WPW patients develop AF, which is a fairly high frequency, and accumulating evidence suggests that this can be life-threatening when associated with high ventricular rates stemming from accessory pathway conduction [17,20]. To be more specific, the presence of AP itself may affect myocardial electrophysiology and contractile properties, thereby increasing AF vulnerability, which is in turn suspected to be involved in the occurrence of AF in patients with the WPW syndrome [21]. ...
Purpose
The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE).
Methods
All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls.
Results
Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both P<0.05). Echocardiography revealed that the maximum left atrial volume (LAVmax) and the left ventricular mass index (LVMI) in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05). Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA) in the WPW patients group compared with patients in the DAVNP group (all P<0.05). In the AF group, there were significant differences in the levels of systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) from the 4-chamber view (LA) both before and after ablation (all P<0.05). In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA) pre-ablation compared to post-ablation (all P<0.05).
Conclusion
Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period.
... The symptoms include palpitations, dizziness, syncope, and dyspnea. The diagnosis of WPW syndrome is usually made by electrocardiogram findings, but further testing may be warranted to confirm the diagnosis (Valderrama et al., 2004;Erdem et al., 2010). The most frequently encountered tachycardia in WPW syndrome is the reentrant tachycardia. ...
In Wolff-Parkinson-White Syndrome (WPW), presence of accessory conduits causes various signs and clinical conditions in patients. WPW syndrome is presently defined as a congenital defect involving the occurrence of abnormal conductive tissue between the atria and the ventricles in relation to supraventricular tachycardia (SVT). SVT is observed in this group of patients. WPW syndrome at high rates can be mixed with SVT. Calcium channel blockers (diltiazem, verapamil) that are one of the most preferred medicines for rate control in patients with SVT may lead to fatal risks in individuals with WPW syndrome. In our presentation, we studied, in parallel to the literature, the case of a patient who presents the WPW syndrome but who is followed as a SVT without performing the electrophysiological tests in parallel to the literature.
J. Exp. Clin. Med., 2013; 30:357-359
... 1,4 Early detection of symptomatic WPW syndrome can give appropiate treatment and save patient's life from suddent cardiac death. 3,4,[6][7][8][9][10] ...
Palpitation is a common presenting symptom in the emergency department. Wolf-Parkinson White (WPW) syndrome is a cardiac conduction disorder that may present with palpitation and lead to sudden cardiac death. WPW could be detected by electrocardiogram (ECG). In this case report, we present two young male patients with WPW syndrome admitted to our hospital with history of repeated and progressive palpitation. ECG of the first patient revealed supraventricular tachycardia which converted to sinus rhythm after propanolol treatment. ECG showed sinus rhythm with delta wave in lead II,III,aVF, V1 suggesting the presence of accessory pathway (AP) in left lateral wall. Electrophysiology study confirmed the presence of AP and radio frequency catheter ablation was successfully done resulted in disappearance of delta on outpatient clinic ECG. Patient has no symptom and he do not have to take medication. ECG of the second patient revealed supraventricular tachycardia with abberancy. After amiodarone infusion, ECG showed sinus rhythm with delta wave in lead I,II,aVL suggesting the presence of accessory pathway in anteroseptal wall. Electrophysiology study and catheter ablation did not perform for this patient because of financial problem, however amidarone has to be taken regularly to prevent the recurrence of supraventricular tachycardia. (Med J Indones 2011; 20:298-301)Keywords: ECG, palpitation, supraventricular tachycardia, Wolf- Parkinson White syndrome
