Wolff Parkinson White syndrome

Question 1

What is Wolff Parkinson White?

Answer 1

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

Question 2

How is WPW diagnosed?

Answer 2

(ECG) 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 3

What is WPW type A and type B?

Answer 3

type A (left-sided pathway): dominant R wave in V1
type B (right-sided pathway): no dominant R wave in V1

Question 4

What is the treatment for WPW?

Answer 4

(Definitive treatment) Radio-frequency ablation of accessory pathway
(Medical therapy) sotalol, amiodarone, flecainide