Wolf-Parkinson-White (WPW) Syndrome

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Presentation :

Pathophysiology :

Diagnostic Testing:

• EKG may show delta-waves (ventricular pre-excitation; slurred upstroke of QRS), if conduction occurring through accessory pathway.
• However it is possible to have normal EKG if conduction is occurring through AV node, thus obscuring the presence of accessory pathway

Treatment :

• For active wide-complex tachycardia:
  • If stable: Start Procainamide IV (or other class 1/2 anti-arrhythmics)
  • If unstable: cardioversion
• Ablation of accessory pathway for any pts with pre-excitation and symptoms
• In pt's with AF and WPW must AVOID usage of BB/CaBlockers/digoxin which may block AV node and induce VT or VF
• Asymptomatic WPW conduction without arrhythmia does not require further testing/treatment

Prognosis:

• AF associated with WPW may progress to VT/VF!

References: