Wolff-Parkinson-White Syndrome

Question 1

PATHOLOGY: WPW

Answer 1

• Atrial re-entry tachycardia

- Accessory pathway links atrium to ventricle (Bundle of Kent)

Question 2

AETIOLOGY: WPW

Answer 2

-Congenital

Question 3

CLINICAL FEATURES: WPW

Answer 3

• Palpitations
• Dizziness
• Collapse
• Tachycardia

Question 4

What conditions are associated with WPW?

Answer 4

• HOCM
• Mitral valve prolapse
• Ebstein’s anomaly
• Thyrotoxicosis
• Secundum ASD

Question 5

INVESTIGATIONS: WPW

Answer 5

• short PR interval
• wide QRS complexes with a slurred upstroke - ‘delta wave’
• left axis deviation if right-sided accessory pathway*
• right axis deviation if left-sided accessory pathway*

Question 6

MANAGEMENT: WPW

Answer 6

• Definitive treatment: radiofrequency ablation of the accessory pathway
• Medical therapy: Sotalol (unless AF), amiodarone, flecainide