1.27.2012

WPW syndrome

Posted on 1:14 AM by know about heart


It is syndrome in which there is an accessory pathway that bypasses the AV node & connects the atrium & ventricle.
Types of WPW syndrome: Two types-
1)    Type-A: Accessory pathway on the left side. ECG findings are-tall R waves in V1 & V2.
2)    Type-B: Accessory pathway on right side ECG findings are deep a waves in V1 & V2.
ECG criteria:
§ Short PR interval (<0.12 second)
§ wide QRS complexes
§ Delta wave: Slurred, thickened initial upstroke of the QRs.
§Presence of Q-wave in leads II, III & a VF (may be confused with inferior MI)
§ Tall R in V1 & V2. (In type-A)
§ Deep Q in V1 & V2. (In type-B)
Clinical presentation of WPW syndrome:
(a) May be asymptomatic (in 50% cases)
(b) Palpitation.
(c) Paroxysmal attack of atrial or supraventricular tachycardia.
(d) Atrial fibrillation or flutter.
(e) Syncope
(f) Sudden death
(g) Rarely VT or VF.
Treatment of WPW syndrome:
i)                   Asymptomatic-No Rx is needed.
ii)                Symptomatic-
                     Radiofrequency ablation is the treatment for choice for WPW syndromes. If not available-prophylactically anti-arrhythmic drugs such as-
           § Amidarone,
           §Beta blocker,
           § Flecainide 
           §propafenone 


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