DOI:10.1111/j.-Parkinson-White Syndrome ElectrocardiogramĬlassic Wolff-Parkinson-White syndrome EKG shows the electrocardiographic signs of pre-excitation. Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome. Arruda MS, McClelland JH, Wang X, Beckman KJ, Widman LE, Gonzalez MD, Nakagawa H, Lazzara R, and Jackman WM.North American Society of Pacing and Electrophysiology. A Consensus Statement from the Cardiac Nomenclature Study Group, Working Group of Arrythmias, European Society of Cardiology, and the Task Force on Cardiac Nomenclature from NASPE. Living anatomy of the atrioventricular junctions. Cosío FG, Anderson RH, Becker A, Borggrefe M, Campbell RW, Gaita F, Guiraudon GM, Haïssaguerre M, Kuck KJ, Rufilanchas JJ, Thiene G, Wellens HJ, Langberg J, Benditt DG, Bharati S, Klein G, Marchlinski F, and Saksena S.An algorithm for the electrocardiographic localization of accessory pathways in the Wolff-Parkinson-White syndrome. Milstein S, Sharma AD, Guiraudon GM, and Klein GJ. ![]() A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff-Parkinson-White syndrome. Pappone C, Santinelli V, Manguso F, Augello G, Santinelli O, Vicedomini G, Gulletta S, Mazzone P, Tortoriello V, Pappone A, Dicandia C, and Rosanio S.Depending on the type of arrhythmias that occur anti-arrhythmic therapy can play a role. WPW can be treated by destroying the accessory bundle with ablation therapy. The occurence of very fast arrhythmias during spontanous attacks of atrial fibrillation (> 240 bpm).The accessory bundle responds to blockade by medication (especially sodium channel blockers)Ĭharacteristics of a malign accessory bundle.Sudden disappearing of the pre-exitation pattern during exercise testing.Intermittant WPW pattern on Holter registration.In clinical practice it is therefore important to distinguish benign from malign accessory bundles.Ĭharacteristics of a benign accessory bundle This fast arrhythmia also carries the risk to deteriorate into ventricular fibrillation and sudden death. Atrial fibrillation in WPW can result in a fast and irregular tachycardia: Fast, Broad & Irregular (FBI). A typical example is atrial fibrillation. A supraventricular tachycardia with 1:1 conduction through the accessory bundle.Also the PQ time is shorter ( 200 bpm) can deteriorate into ventricular fibrillation and sudden death. The QRS-complex is somewhat widened (> 0.10 sec). ![]() This is shown on the ECG as a delta wave. The part of the ventricle where this accessory bundle connects are the first to depolarize. The pre-exitation pattern is caused by an extra connection between the atria and the ventricles (accessory bundle) that forms an electrical bypass to the AV node. The prevalence of the WPW or pre-exitation pattern is relatively common in the general population (about 0.15-0.25%). Not all patients with a WPW pattern on the ECG are symptomatic. Their ECGs showed two abnormalities: a short PQ time and a delta-wave.Įver since one speaks of the Wolff-Parkinson-White syndrome in patients with complaints of syncope and / or tachycardia and a pre-exitation pattern on the ECG (WPW syndrome = WPW pattern + symptoms). ![]() In 1930 Louis Wolff, Sir John Parkinson and Paul Dudley White described 11 patients who suffered from bouts of tachcyardias. The electrical signal travels from the ventricles via the accessory bundle to the atria and returns to the ventricles via the AV node. A atrioventricular tachycardia through the accessory bundle.
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