WolffParkinsonWhite WPW syndrome - Biotech, Pharma and Life Science Channel
Wolff–Parkinson–White syndrome (WPW) is a syndrome of pre-excitation of ventricles of the heart due to an accessory pathway known as the bundle of Kent. This accessory pathway is an abnormal electrical communication from the atria to the ventricles. WPW is a type of atrioventricular reentrant tachycardia. The incidence of WPW syndrome is between 0.1% and 0.3% of the general population. While the vast majority of individuals with a bundle of Kent remain asymptomatic throughout their entire lives, there is a risk of sudden death associated with the syndrome. Sudden death due to WPW syndrome is rare (incidence of less than 0.6%), and is due to the effect of the accessory pathway on tachyarrhythmias in these individuals.
Acutely, people with WPW who are experiencing tachyarrhythmias may require synchronized electrical cardioversion if their condition is critical (they are hypotensive or lethargic with altered mental status), or, if more stable, medical treatment may be used. Patients with atrial fibrillation and rapid ventricular response are often treated with amiodarone or procainamide to stabilize their heart rate. Procainamide, amiodarone, and cardioversion are now accepted treatments for conversion of tachycardia found with WPW. Adenosine and other AV node blockers and beta blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it. Patients with a rapid heart beat with narrow QRS complexes (circus movement tachycardias) may also be cardioverted, alternatively, adenosine may be administered if equipment for cardioversion is immediately available as a backup.
The definitive treatment of WPW syndrome is a destruction of the abnormal electrical pathway by radiofrequency catheter ablation. This procedure is performed almost exclusively by cardiac electrophysiologists. Radiofrequency catheter ablation is not performed in all individuals with WPW syndrome because there are inherent risks involved in the procedure. When performed by an experienced electrophysiologist, radiofrequency ablation has a high success rate. Recurrence rates are typically less than 5% after a successful ablation.
Classic electrocardiographic (ECG) findings that are associated with WPW syndrome include the following:
* Presence of a short PR interval (<120 ms)
* A wide QRS complex of longer than 120 milliseconds with a slurred onset of the QRS waveform producing a delta wave in the early part of QRS
* Secondary ST-T wave changes
Source; PaceMaker Project
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