Wolff-Parkinson-White Syndrome

Genetic disorder that allows abnormal conduction to occur in the heart via an accessory pathway

Aetiology

  • Congenital condition

Pathophysiology

  • Patients possess an accessory pathway known as the Bundle of Kent which allows the signal to return to the atria from the ventricles
  • This creates a re-entrant loop that predisposes to tachyarrythmias - atrial fibrillation, atrial flutter and AVRT

Clinical presentation

  • Often asymptomatic incidental finding
  • Acute episodes of SVT - palpitations, dyspnoea, tachycardia

Investigations

ECG

  • Slurred upstroke on the QRS complex (delta wave) - pre-excitation
  • Short PR interval (< 0.12 seconds)
  • Wide QRS complex (> 0.12 seconds)
notion image
notion image

Management

  • Treat AF/atrial flutter/AVRT as in notes
  • Definitive treatment is radiofrequency ablation of the accessory pathway