Wolff-Parkinson White

Question 1

what is Wolf parksinon white syndrome ?

Answer 1

congenital accessory conducting pathway between the atria and ventricles leading to atrioventricular re-entry tachycardia (AVRT). As the accessory pathway does not slow conduction AF can degenerate rapidly to VF.

Question 2

ECG findings of WPW

Answer 2

short PR interval

wide QRS complexes with a slurred upstroke - ‘delta wave’

Wolff-Parkinson-White syndrome is associated with left axis deviation
(right axis deviation if left-sided accessory pathway)

Question 3

type A (left-sided pathway) dominant R wave

Answer 3

v1

Question 4

type B (right-sided pathway)

Answer 4

no dominant R wave in V1

Question 5

etiology of WPW syndrome

Answer 5

HOCM
mitral valve prolapse
Ebstein’s anomaly
thyrotoxicosis
secundum ASD

Question 6

x

Question 7

x

Question 8

x

Question 9

x

Question 10

x

Question 11

MX of WPW

Answer 11

definitive treatment: radiofrequency ablation of the accessory pathway

medical therapy: sotalol, amiodarone, flecainide

Question 12

when should stall be avoidedd in WPW ?

Answer 12

if there is coexistent atrial fibrillation as prolonging the refractory period at the AV node may increase the rate of transmission through the accessory pathway, increasing the ventricular rate and potentially deteriorating into ventricular fibrillation