Wolff-Parkinson-White syndrome overview: Difference between revisions
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==Overview== | ==Overview== | ||
[[Wolff-Parkinson-White]] ([[WPW]]) syndrome is the most common cause of [[ventricular pre-excitation]] and the second common cause of [[supraventricular tachycardia]]. There is a [[muscle fiber]] that bridges the [[atrioventricular groove]] providing electrical continuity between the atrium and ventricle in parallel to the [[atrioventricular node-His-Purkinje axis]]. The [[atrial]] impulse activates the entire or part of the [[ventricle]] or the [[ventricular impulse]] activates the entire [[atrium]] or part of it, earlier than normally be expected. Patients with [[WPW syndrome]] may present with abrupt [[palpitation]], [[presyncope]], [[syncope]], or [[ sudden cardiac death]]([[SCD]]). In some patients, [[SCD]] is the first presentation of [[WPW syndrome]], especially in the setting of [[atrial fibrillation]] with a [[rapid ventricular response]]. [[Wolff-Parkinson-White syndrome]] is named after the cardiologists [[Louis Wolff]], John Parkinson, and [[Paul Dudley White]] who gave a definitive description of the conduction disorder of the heart in 1930. The term [[Wolff-Parkinson-White syndrome]] was coined in 1940. [[Bundle of Kent]] was first discovered by [[Albert Frank Stanley Kent]], a British physiologist following finding the lateral branch in the atrioventricular groove of the monkey heart. Wolff-Parkinson-White ([[WPW]]) syndrome is the occurrence of [[arrhythmia]] in the presence of an [[accessory pathway]]. [[WPW]] can be classified according to the site of origin, location in the [[mitral]] or [[tricuspid]] annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based of the type of [[atrioventricular reciprocating tachycardia]] ([[AVRT]]) it causes, which can be either orthodromic (~95% of the cases) or antidromic. | [[Wolff-Parkinson-White]] ([[WPW]]) syndrome is the most common cause of [[ventricular pre-excitation]] and the second common cause of [[supraventricular tachycardia]]. There is a [[muscle fiber]] that bridges the [[atrioventricular groove]] providing electrical continuity between the atrium and ventricle in parallel to the [[atrioventricular node-His-Purkinje axis]]. The [[atrial]] impulse activates the entire or part of the [[ventricle]] or the [[ventricular impulse]] activates the entire [[atrium]] or part of it, earlier than normally be expected. Patients with [[WPW syndrome]] may present with abrupt [[palpitation]], [[presyncope]], [[syncope]], or [[ sudden cardiac death]]([[SCD]]). In some patients, [[SCD]] is the first presentation of [[WPW syndrome]], especially in the setting of [[atrial fibrillation]] with a [[rapid ventricular response]]. [[Wolff-Parkinson-White syndrome]] is named after the cardiologists [[Louis Wolff]], John Parkinson, and [[Paul Dudley White]] who gave a definitive description of the conduction disorder of the heart in 1930. The term [[Wolff-Parkinson-White syndrome]] was coined in 1940. [[Bundle of Kent]] was first discovered by [[Albert Frank Stanley Kent]], a British physiologist following finding the lateral branch in the atrioventricular groove of the monkey heart. Wolff-Parkinson-White ([[WPW]]) syndrome is the occurrence of [[arrhythmia]] in the presence of an [[accessory pathway]]. [[WPW]] can be classified according to the site of origin, location in the [[mitral]] or [[tricuspid]] annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based of the type of [[atrioventricular reciprocating tachycardia]] ([[AVRT]]) it causes, which can be either orthodromic (~95% of the cases) or antidromic.In normal individuals, electrical activity in the heart is initiated in the [[sinoatrial node|sinoatrial]] (SA) node (located in the [[right atrium]]), propagates to the [[atrioventricular node|atrioventricular]] (AV) node, and then through the [[bundle of His]] to the ventricles of the heart. Individuals with [[Wolf-parkinson-White]] ([[WPW]]) have an [[accessory pathway]], known as the [[bundle of Kent]], that communicates between the [[atria]] and the [[ventricles]]. The conduction through the accessory pathway can be bidirectional (most commonly), only retrogarde (less common), or only antegrade (least common). The most common type of tachycardia associated with WPW is [[atrioventricular reciprocating tachycardia]] ([[AVRT]]). The accessory pathway does not share the rate-slowing properties of the [[AV node]]; therefore, the combination of an accessory pathway and cardiac [[arrhythmia]] can trigger [[ventricular fibrillation]], a leading cause of [[sudden cardiac death]]. | ||
==Historical Perspective== | ==Historical Perspective== | ||
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==Classification== | ==Classification== | ||
[[Wolff-Parkinson-White]] ([[WPW]]) syndrome is the occurrence of [[arrhythmia]] in the presence of an [[accessory pathway]]. [[WPW]] can be classified according to the site of origin, location in the [[mitral]] or [[tricuspid]] annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based | [[Wolff-Parkinson-White]] ([[WPW]]) syndrome is the occurrence of [[arrhythmia]] in the presence of an [[accessory pathway]]. [[WPW]] can be classified according to the site of origin, location in the [[mitral]] or [[tricuspid]] annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based on the type of [[atrioventricular reciprocating tachycardia]] ([[AVRT]]) it causes, which can be either orthodromic (~95% of the cases) or antidromic. | ||
==Pathophysiology== | ==Pathophysiology== | ||
In normal individuals, electrical activity in the heart is initiated in the [[sinoatrial node|sinoatrial]] (SA) node (located in the [[right atrium]]), propagates to the [[atrioventricular node|atrioventricular]] (AV) node, and then through the [[bundle of His]] to the ventricles of the heart. Individuals with [[Wolf-parkinson-White]] ([[WPW]]) have an [[accessory pathway]], known as the [[bundle of Kent]], that communicates between the [[atria]] and the [[ventricles]]. The conduction through the accessory pathway can be bidirectional (most commonly), only retrogarde (less common), or only antegrade (least common). The most common type of tachycardia associated with WPW is [[atrioventricular reciprocating tachycardia]] ([[AVRT]]). The accessory pathway does not share the rate-slowing properties of the [[AV node]]; therefore, the combination of an accessory pathway and cardiac [[arrhythmia]] can trigger [[ventricular fibrillation]], a leading cause of [[sudden cardiac death]]. | |||
==Causes== | ==Causes== | ||
Revision as of 19:42, 9 November 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Zand, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]
Overview
Wolff-Parkinson-White (WPW) syndrome is the most common cause of ventricular pre-excitation and the second common cause of supraventricular tachycardia. There is a muscle fiber that bridges the atrioventricular groove providing electrical continuity between the atrium and ventricle in parallel to the atrioventricular node-His-Purkinje axis. The atrial impulse activates the entire or part of the ventricle or the ventricular impulse activates the entire atrium or part of it, earlier than normally be expected. Patients with WPW syndrome may present with abrupt palpitation, presyncope, syncope, or sudden cardiac death(SCD). In some patients, SCD is the first presentation of WPW syndrome, especially in the setting of atrial fibrillation with a rapid ventricular response. Wolff-Parkinson-White syndrome is named after the cardiologists Louis Wolff, John Parkinson, and Paul Dudley White who gave a definitive description of the conduction disorder of the heart in 1930. The term Wolff-Parkinson-White syndrome was coined in 1940. Bundle of Kent was first discovered by Albert Frank Stanley Kent, a British physiologist following finding the lateral branch in the atrioventricular groove of the monkey heart. Wolff-Parkinson-White (WPW) syndrome is the occurrence of arrhythmia in the presence of an accessory pathway. WPW can be classified according to the site of origin, location in the mitral or tricuspid annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based of the type of atrioventricular reciprocating tachycardia (AVRT) it causes, which can be either orthodromic (~95% of the cases) or antidromic.In normal individuals, electrical activity in the heart is initiated in the sinoatrial (SA) node (located in the right atrium), propagates to the atrioventricular (AV) node, and then through the bundle of His to the ventricles of the heart. Individuals with Wolf-parkinson-White (WPW) have an accessory pathway, known as the bundle of Kent, that communicates between the atria and the ventricles. The conduction through the accessory pathway can be bidirectional (most commonly), only retrogarde (less common), or only antegrade (least common). The most common type of tachycardia associated with WPW is atrioventricular reciprocating tachycardia (AVRT). The accessory pathway does not share the rate-slowing properties of the AV node; therefore, the combination of an accessory pathway and cardiac arrhythmia can trigger ventricular fibrillation, a leading cause of sudden cardiac death.
Historical Perspective
Wolff-Parkinson-White syndrome is named after the cardiologists Louis Wolff, John Parkinson, and Paul Dudley White who gave a definitive description of the conduction disorder of the heart in 1930. The term Wolff-Parkinson-White syndrome was coined in 1940. Bundle of Kent was first discovered by Albert Frank Stanley Kent, a British physiologist following finding the lateral branch in the atrioventricular groove of the monkey heart.
Classification
Wolff-Parkinson-White (WPW) syndrome is the occurrence of arrhythmia in the presence of an accessory pathway. WPW can be classified according to the site of origin, location in the mitral or tricuspid annulus, type of conduction (antegrade vs retrograde), and characteristics of the conduction (decremental vs nondecremental). In addition, WPW can be classified based on the type of atrioventricular reciprocating tachycardia (AVRT) it causes, which can be either orthodromic (~95% of the cases) or antidromic.
Pathophysiology
In normal individuals, electrical activity in the heart is initiated in the sinoatrial (SA) node (located in the right atrium), propagates to the atrioventricular (AV) node, and then through the bundle of His to the ventricles of the heart. Individuals with Wolf-parkinson-White (WPW) have an accessory pathway, known as the bundle of Kent, that communicates between the atria and the ventricles. The conduction through the accessory pathway can be bidirectional (most commonly), only retrogarde (less common), or only antegrade (least common). The most common type of tachycardia associated with WPW is atrioventricular reciprocating tachycardia (AVRT). The accessory pathway does not share the rate-slowing properties of the AV node; therefore, the combination of an accessory pathway and cardiac arrhythmia can trigger ventricular fibrillation, a leading cause of sudden cardiac death.