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Wolff-Parkinson-White Syndrome

This is a heart disorder occurring in approximately 0.1%-0.3% of the general population.

It is a type of pre-excitation syndrome, meaning that the ventricles depolarise (and therefore contract) prematurely.

Normally the atria and ventricles are isolated, with an electrical impulse only being able to spread from one to the other by the atrioventricular node which delays and reduces the strength of the initial impulse so ventricular contraction is regulated and does not occur too soon or too frequently.

Individuals with WPW however have an accessory pathway (as shown above) called the bundle of Kent which creates another electrical connection between the atria and ventricles, bypassing the atrioventricular node. The bundle of Kent does not delay nor reduce the strength of the initial impulse and may even increase the speed at which it is transmitted. This causes premature contraction of the ventricles and tachycardia (rapid heart rate).

When coupled with cardiac dysrhythmia (irregular heart beat), individuals with an accessory pathway have an increased risk of ventricular fibrillation. Severe tachycardia may lead to cardiogenic shock (inadequate blood circulation due to premature ventricular contraction/arrhythmia). These create a very small risk of sudden cardiac death, occurring in approximately <0.6% of WPW sufferers.

Symptoms

Many people may remain asymptomatic throughout their lives however symptoms most commonly found in WPW patients are:

Chest pain or tightness

Dizziness

Syncope (fainting)

Palpatations

Shortness of breath

Diagnosis (using an ECG when in normal sinus rhythm)

A delta wave can often be observed (manifested as a slurred upstroke beginning the QRS complex).

Short PR interval <120milliseconds

Widened QRS complex >120milliseconds

Treatment of WPW is a destruction of the abnormal electrical pathway by radiofrequency catheter ablation (an invasive procedure involving flexible catheters being threaded through the patients blood vessels to the heart and an electrical impulse being given to destroy the accessory pathway).