Wolff-Parkinson-White syndrome overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Wolff-Parkinson-White (WPW) syndrome is the most common cause of ventricular pre-excitation and the second common cause of supraventricular tachycardia due to defects in the conduction pathway. 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 (WPW) is a syndrome of pre-excitation of the ventricles of the heart due to an accessory pathway known as the Bundle of Kent. This accessory pathway is a congenital abnormal electrical communication from the atria to the ventricles causing them to contract prematurely, resulting in a unique type of supraventricular tachycardia referred to as an atrioventricular reciprocating tachycardia. The accessory pathway is the consequence of the lack of complete fusion between the suculus and the endocardiac cushion tissue which should be completed by the 12th week of gestation.[1][2]
The incidence of WPW syndrome is between 0.1 and 0.3% of the general population.[3][4][5][6]
The majority of individuals with WPW syndrome doesn't present symptoms, nearly 65% of adolescents and 40% of adults present ECG changes but remain asymptomatic. Though risk of sudden death is associated with WPW, is a very rare condition. Last reports show an incidence of 4.5 per 1000 patients with WPW presented with sudden death.[3]
References
- ↑ Wessels, A.; Markman, M.W.M.; Vermeulen, J.L.M.; Anderson, R.H.; Moorman, A.F.M.; Lamers, W.H. (1996). "The Development of the Atrioventricular Junction in the Human Heart". Circulation Research. 78 (1): 110–117. doi:10.1161/01.RES.78.1.110. ISSN 0009-7330.
- ↑ Ho, S. Y. (2008). "Accessory Atrioventricular Pathways: Getting to the Origins". Circulation. 117 (12): 1502–1504. doi:10.1161/CIRCULATIONAHA.107.764035. ISSN 0009-7322.
- ↑ 3.0 3.1 Pediatric and Congenital Electrophysiology Society (PACES). Heart Rhythm Society (HRS). American College of Cardiology Foundation (ACCF). American Heart Association (AHA). American Academy of Pediatrics (AAP). Canadian Heart Rhythm Society (CHRS); et al. (2012). "PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS)". Heart Rhythm. 9 (6): 1006–24. doi:10.1016/j.hrthm.2012.03.050. PMID 22579340.
- ↑ Rosner MH, Brady WJ Jr, Kefer MP, Martin ML. (1999). "Electrocardiography in the patient with the Wolff-Parkinson-White syndrome: diagnostic and initial therapeutic issues". American Journal of Emergency Medicine. 17 (7): 705–14. PMID 10597097.
- ↑ Sorbo MD, Buja GF, Miorelli M, Nistri S, Perrone C, Manca S, Grasso F, Giordano GM, Nava A. (1995). "The prevalence of the Wolff-Parkinson-White syndrome in a population of 116,542 young males". Giornale Italiano di Cardiologia (in Italian). 25 (6): 681–7. PMID 7649416.
- ↑ Munger TM, Packer DL, Hammill SC, Feldman BJ, Bailey KR, Ballard DJ, Holmes DR Jr, Gersh BJ. (1993). "A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989". Circulation. 87 (3): 866–73. PMID 8443907.