Wolff-Parkinson-White (WPW) Syndrome and ECG Findings

Introduction

Wolff-Parkinson-White (WPW) syndrome is a congenital heart condition characterized by an abnormal electrical pathway in the heart, leading to episodes of tachycardia (rapid heart rate). It is diagnosed primarily through electrocardiography (ECG), which shows characteristic patterns.

ECG Features of WPW

An ECG in WPW syndrome typically presents the following findings:

  • Short PR interval (<120 ms) due to the early activation of the ventricles.
  • Delta wave – a slurred upstroke of the QRS complex caused by pre-excitation through an accessory pathway.
  • Widened QRS complex (>120 ms) due to the abnormal conduction pathway.

Clinical Significance

WPW syndrome can lead to dangerous arrhythmias such as atrial fibrillation with rapid conduction through the accessory pathway, increasing the risk of sudden cardiac events.

Diagnosis and Treatment

  • Diagnosis: Made based on ECG findings and, if needed, electrophysiological studies.
  • Treatment: Options include catheter ablation (curative), antiarrhythmic medications, and in emergencies, synchronized cardioversion.

Conclusion

WPW syndrome is a significant cardiac condition that can lead to arrhythmias if left untreated. Proper diagnosis and management can reduce risks and improve patient outcomes.

Source recommendations

1. European Society of Cardiology Guidelines on Management of Supraventricular Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  2. https://academic.oup.com/eurheartj/article/41/5/655/5556821
  3. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
  4. https://pubmed.ncbi.nlm.nih.gov/14563598/
  5. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

2. American Heart Association Guidelines for the Evaluation and Management of Arrhythmias

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  2. https://pubmed.ncbi.nlm.nih.gov/30586772/
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  4. https://www.heartrhythmjournal.com/article/S1547-5271(22)01946-4/fulltext
  5. https://www.ahajournals.org/doi/10.1161/cir.0000000000000499

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