Wolff-Parkinson-White syndrome diagnosis overview: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnose of WPW pattern is commonly made by an incidental [[electrocardiogram|ECG]] finding in an [[asymptomatic]] | * The diagnose of WPW pattern is commonly made by an incidental [[electrocardiogram|ECG]] finding in an [[asymptomatic]] individuals. | ||
* The characteristic [[EKG]] finding is a [[delta wave]], which represents the pre-excitation of the [[ventricles]] through the [[accessory pathway]] | |||
Patients WPW syndrome with episodes of atrial fibrillation will present ECG with rapid polymorphic wide-complex tachycardia.<ref name="Fengler-2007">{{Cite journal | last1 = Fengler | first1 = BT. | last2 = Brady | first2 = WJ. | last3 = Plautz | first3 = CU. | title = Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. | journal = Am J Emerg Med | volume = 25 | issue = 5 | pages = 576-83 | month = Jun | year = 2007 | doi = 10.1016/j.ajem.2006.10.017 | PMID = 17543664 }}</ref> This combination of atrial fibrillation and WPW is considered dangerous as a high risk of [[ventricular fibrillation]] is present. | * This phenomenon presents because the [[AV node]] has the property of slowing the impulses, therefore the the conduction throuhg the [[accessory pathway]] is faster, therefore the [[ventricles]] are excited through two different pathways.<ref name="Sethi-2007">{{Cite journal | last1 = Sethi | first1 = KK. | last2 = Dhall | first2 = A. | last3 = Chadha | first3 = DS. | last4 = Garg | first4 = S. | last5 = Malani | first5 = SK. | last6 = Mathew | first6 = OP. | title = WPW and preexcitation syndromes. | journal = J Assoc Physicians India | volume = 55 Suppl | issue = | pages = 10-5 | month = Apr | year = 2007 | doi = | PMID = 18368860 }}</ref> | ||
* The [[delta wave]] is an upstroke in the [[R wave]] of the [[QRS]] complex that is associated with a short [[PR interval]]. | |||
Patients with WPW can exhibit more than one [[accessory pathway]] | * [[Delta waves]] are only present when the patient is in sinus rhythm, when tachycardia starts the delta wave is no longer present. | ||
* Patients [[WPW]] syndrome with episodes of [[atrial fibrillation]] will present [[ECG ]] with rapid polymorphic [[wide-complex tachycardia]].<ref name="Fengler-2007">{{Cite journal | last1 = Fengler | first1 = BT. | last2 = Brady | first2 = WJ. | last3 = Plautz | first3 = CU. | title = Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. | journal = Am J Emerg Med | volume = 25 | issue = 5 | pages = 576-83 | month = Jun | year = 2007 | doi = 10.1016/j.ajem.2006.10.017 | PMID = 17543664 }}</ref> | |||
Wolff-Parkinson-White syndrome is sometimes associated with [[Leber's hereditary optic neuropathy]] (LHON), a form of [[mitochondrial disease]] | * This combination of [[atrial fibrillation]] and [[WPW]] is considered dangerous as a high risk of [[ventricular fibrillation]] is present. | ||
* [[AV node]] blocking agents are contraindicated in these patients because it will enhance the conduction through the [[accessory pathway]]. | |||
* Patients with [[WPW]] can exhibit more than one [[accessory pathway]] which is common in patientds with [[Ebstein's anomaly]].<ref name="europace.oxfordjournals.org">{{Cite web | last = | first = | title = Radiofrequency ablation of multiple accessory pathways | url = http://europace.oxfordjournals.org/content/4/3/273 | publisher = | date = | accessdate = 14 April 2014 }}</ref> | |||
* [[Wolff-Parkinson-White syndrome]] is sometimes associated with [[Leber's hereditary optic neuropathy]] (LHON), a form of [[mitochondrial disease]].<ref name="Nikoskelainen-1994">{{Cite journal | last1 = Nikoskelainen | first1 = EK. | last2 = Savontaus | first2 = ML. | last3 = Huoponen | first3 = K. | last4 = Antila | first4 = K. | last5 = Hartiala | first5 = J. | title = Pre-excitation syndrome in Leber's hereditary optic neuropathy. | journal = Lancet | volume = 344 | issue = 8926 | pages = 857-8 | month = Sep | year = 1994 | doi = | PMID = 7916404 }}</ref><ref name =Mashima_et_al_1996> | |||
{{cite journal | {{cite journal | ||
| author=Mashima Y, Kigasawa K, Hasegawa H, Tani M, Oguchi Y. | | author=Mashima Y, Kigasawa K, Hasegawa H, Tani M, Oguchi Y. | ||
Revision as of 16:50, 6 September 2020
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Wolff-Parkinson-White syndrome Microchapters |
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Differentiating Wolff-Parkinson-White syndrome from other Diseases |
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Wolff-Parkinson-White syndrome diagnosis overview On the Web |
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Risk calculators and risk factors for Wolff-Parkinson-White syndrome diagnosis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
- The diagnose of WPW pattern is commonly made by an incidental ECG finding in an asymptomatic individuals.
- The characteristic EKG finding is a delta wave, which represents the pre-excitation of the ventricles through the accessory pathway
- This phenomenon presents because the AV node has the property of slowing the impulses, therefore the the conduction throuhg the accessory pathway is faster, therefore the ventricles are excited through two different pathways.[1]
- The delta wave is an upstroke in the R wave of the QRS complex that is associated with a short PR interval.
- Delta waves are only present when the patient is in sinus rhythm, when tachycardia starts the delta wave is no longer present.
- Patients WPW syndrome with episodes of atrial fibrillation will present ECG with rapid polymorphic wide-complex tachycardia.[2]
- This combination of atrial fibrillation and WPW is considered dangerous as a high risk of ventricular fibrillation is present.
- AV node blocking agents are contraindicated in these patients because it will enhance the conduction through the accessory pathway.
- Patients with WPW can exhibit more than one accessory pathway which is common in patientds with Ebstein's anomaly.[3]
- Wolff-Parkinson-White syndrome is sometimes associated with Leber's hereditary optic neuropathy (LHON), a form of mitochondrial disease.[4][5]
-
One beat from a rhythm strip in V2 demonstrating characteristic findings in WPW syndrome. Note the characteristic delta wave (subtler here than in some cases), the short PR interval of 0.08 seconds, and the long QRS complex at 0.12 seconds.
References
- ↑ Sethi, KK.; Dhall, A.; Chadha, DS.; Garg, S.; Malani, SK.; Mathew, OP. (2007). "WPW and preexcitation syndromes". J Assoc Physicians India. 55 Suppl: 10–5. PMID 18368860. Unknown parameter
|month=ignored (help) - ↑ Fengler, BT.; Brady, WJ.; Plautz, CU. (2007). "Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED". Am J Emerg Med. 25 (5): 576–83. doi:10.1016/j.ajem.2006.10.017. PMID 17543664. Unknown parameter
|month=ignored (help) - ↑ "Radiofrequency ablation of multiple accessory pathways". Retrieved 14 April 2014.
- ↑ Nikoskelainen, EK.; Savontaus, ML.; Huoponen, K.; Antila, K.; Hartiala, J. (1994). "Pre-excitation syndrome in Leber's hereditary optic neuropathy". Lancet. 344 (8926): 857–8. PMID 7916404. Unknown parameter
|month=ignored (help) - ↑ Mashima Y, Kigasawa K, Hasegawa H, Tani M, Oguchi Y. (1996). "High incidence of pre-excitation syndrome in Japanese families with Leber's hereditary optic neuropathy" (subscription required). Clinical Genetics. 50 (6): 535–7. PMID 9147893.