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Wolf Parkison White Syndrome


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Wolf Parkinson White Syndrome

Wolf Parkison White Syndrome is the increased heart rate caused by abnormally fast electrical conduction in an accessory pathway within the heart bypassing the normal conduction system. The greatest concern for people with WPW is the possibility of having atrial fibrillation with a fast ventricular response that worsens to ventricular fibrillation , a life-threatening arrhythmia. Other people with WPW never have tachycardia or other symptoms. About 80 percent of people with symptoms first have them between the ages of 11 and 50.

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 . It's in a category of electrical abnormalities called "pre-excitation syndromes. It involves activation of the ventricles that occurs earlier than anticipated (preexcitation), which occurs because of conduction of an atrial impulse not by means of the normal conduction system, but via an extra atrioventricular (AV) muscular connection, termed an accessory pathway, that bypasses the AV node. This extra or accessory electrical pathway is present in approximately 1.5 per 1,000 people. It runs in families in less than 1% of cases. In the majority it is completely silent and only detected on a routine ECG Many people with this syndrome who have symptoms or episodes of tachycardia (rapid heart rhythm) may have dizziness, chest palpitations, fainting or, rarely, cardiac arrest. Re-entry arrythmias occur in about 50 percent of people with WPW; some may have atrial fibrillation (a common irregular heart rhythm distinguished by disorganized, rapid, and irregular heart rhythm). This extra pathway may at times encourage a rapid rhythm. Instead of allowing the next heart beat to begin at the SA node, the extra pathway can "pick up" an electrical impulse in the ventricles and send it abnormally back upward to the atria.

If there's an extra conduction pathway, the electrical signal may arrive at the ventricles too soon.Wolff (Wolfe)-Parkinson-White (WPW) is a very rare cause of sudden death. It results from an additional electrical connection between the atria (upper chambers of the heart) and the ventricles (lower chambers of the heart). Although dozens of locations for bypass tracts can exist in preexcitation, including atriofascicular, fasciculoventricular, intranodal, or nodoventricular, the most common bypass tract is an accessory atrioventricular (AV) pathway otherwise known as a Kent bundle. The heart's regular pattern of electrical impulses causes the heart to fill with blood and contract in a normal fashion. From here, the impulse leaves the AV node and spreads down and across both lower chambers, or the ventricles. The ventricles contract, pumping blood to the body. For instance, in the example above, if an individual had an atrial rate of 300 beats per minute, the accessory bundle may conduct all the electrical impulses from the atria to the ventricles, causing the ventricles to activate at 300 beats per minute.

Causes of Wolf Parkison White Syndrome

The common Causes of Wolf Parkison White Syndrome :

  • An accessory pathway is quite likely to be congenital, although its manifestations can be detected in later years and it may appear to be acquired.
  • Wolff-Parkinson-White occurs is one of the most common causes of fast heart rate disorders (tachyarrhythmias) in infants and children.
  • In this case, the extra pathway is often found when a doctor has requested an ECG for some other purpose.
  • Hypertrophic cardiomyopathy may include idiopathic hypertrophic subaortic stenosis or asymmetric septal hypertrophy.
  • In some patients, the extra pathway may result in re-entry supraventricular tachycardia, which is a rapid heart rate that starts above the two bottom chambers of the heart.
  • On the other hand, some people experience temporary rapid heartbeat due to certain drugs, smoking , and anxiety .
  • Relatives of patients with preexcitation, particularly those with multiple pathways, have an increased prevalence of preexcitation, suggesting a hereditary mode of acquisition.

Symptoms of Wolf Parkison White Syndrome

Some are common Symptoms of Wolf Parkison White Syndrome :

  • Palpitations (a sensation of feeling your heart beat)
  • Fainting
  • Shortness of breath
  • Light-headedness
  • Drop in blood pressure.
  • Episodes of markedly accelerated heart rate (usually faster than 200 beats per minute).
  • Dizziness
  • Chest pain or chest tightness
  • Heart palpitations.

Treatment of Wolf Parkison White Syndrome

Here is the list of the methods for treating Wolf Parkison White Syndrome :

  • Other treatments to stop a persistent episode of tachycardia may include electrical cardioversion (shock) or pacemakers designed to interrupt the reentry cycle.
  • This destroys the accessory pathway using a catheter (tube) inserted into the body to reach the heart.
  • However, you must take the medicine carefully because it can sometimes make an abnormal heart rhythm worse.
  • Whether a person will be treated with medication or with an ablation procedure depends on several factors.
  • Thus, standard treatments for non-WPW AFib must be avoided and replaced by cardioversion with the possibility of procainamide as a potential medical therapeutic alternative.
  • The success rate for this procedure ragnes between 85 - 95%, depending on the location of the extra pathway.
  • Surgery may be a good approach to cure symptomatic Wolff-Parkinson-White syndrome, but it is usually only done if the patient must undergo surgery for other reasons.
  • Cardioversion, or in some cases, procainamide, are the treatment choices in these situations (ie, irregular QRS complex), providing the necessary rate control.