Table Of Contents

Wolff-Parkinson-White Syndrome (WPW)

General

Clinical Presentation

Wolff-Parkinson-White (WPW) syndrome and pattern

Wolff-Parkinson-White (WPW) syndrome and pattern

Diagnosis

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Treatment

  1. Unstable Arrhythmia

  2. Orthodromic AVRT (narrow QRS)

    <aside> ⛔ Both C.I. with irregular rhythm [eg, AF] → because AV-node blockers promote more conduction through the accessory pathway → ↑ rapid ventricular response.

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  3. **Antidromic AVRT or Atrial Fibrillation (wide complex)**

  4. Definitive Therapy

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What is the recommended temporary management for a hemodynamically stable Wolff-Parkinson-White syndrome patient with atrial fibrillation?

Atrioventricular Re-entrant Tachycardia (AVRT)

Wolff-Parkinson-White syndrome is a common cause of AVRT but they are not synonymous WPW is an ECG pattern based on an aberrant pathway, AVRT is a complication in form of arrhythmia.


ECG findings in AVRT

Type ECG Findings
Orthodromic AVRT 🔷 Heart rate 150–250/minute
🔷 Regular rhythm
🔷 Narrow QRS complex
🔷 P wave typically follows QRS complex.
🔷 Can be indistinguishable from AVNRT
Antidromic AVRT 🔷 Heart rate 150–250/minute
🔷 Regular rhythm
🔷 Wide QRS complex (similar in appearance to ventricular tachycardia, preexcited focal atrial tachycardia, and preexcited atrial flutter)
🔷 Shortened PR interval

Orthodromic and antidromic AVRT

Orthodromic and antidromic AVRT

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During an attack of tachyarrythmia → delta waves and delta waves may not be present!

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AVRT is caused by an accessory pathway, whereas in AVNRT there are two functional pathways within the AV node.

Brugada Syndrome

General

Diagnosis

Management

Congenital Long QT Syndrome (LQTS)