Wolf-Parkinson-White (WPW) Syndrome: Infographic

WPW wolf parkinson white syndrome
Wolff-Parkinson-White (WPW) Syndrome Characterized by presence of accessory pathway (bundle of Kent) between atria and ventricle that can cause “preexcitation” or earlier activation of the His-Purkinje system. ECG Features Delta wave: slow muscle- fiber-to-muscle-fiber conduction WPW pattern: Preexcitation pattern on ECG without symptomatic arrhythmias WPW Syndrome: ECG findings + arrhythmias Pathway Associated Arrhythmia Atrioventricular reentrant tachycardia (AVRT) commonly occurs in WPW where the reentrant circuit is formed through the accessory pathway AFib and WPW M Visualmed Characteristic finding: irregularly irregular rhythm with QRS morphology that variates beat to beat www Afib or flutter conducting through the accessory pathway can degenerate into ventricular fibrillation conduction through normal pathway – normal PR interval – normal QRS complex conduction through accessory pathway – PR interval < 120 ms Slurred upsloping of Q wave (Delta wave) Orthodromic AVRT Impulse travels down the AV node and up the accessory pathway Antidromic AVRT Impulse travels down the accessory pathway and up the AV node AV nodal blockers and WPW AVN blockers such as verapamil, adenosine, digoxin can increase the conduction of impulse through the accessory pathway and can increase the risk of Vfib in patients with WPW and AF Risk Stratification Intermittent loss of preexcitation with any of the following tests is a good prognostic indicator and is considered as low risk for SCD: wh ... HM- Treatment Did you know: 'Epstein anomaly' is the most common congenital anomaly associated with WPW syndrome HM- Acute medical management Afib and WPW procainamide avoid AVN blockers cardioversion if unstable Prevention catheter ablation Source: Circulation 2016; 133:e506. 12-lead ECG Exercise treadmill test Holter monitor Procainamide challenge Orthodromic AVRT vagal maneuvers adenosine, verapamil Antidromic AVRT procainamide