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

Brugada pattern

Brugada pattern

Congenital Long QT Syndrome (LQTS)