Wolff-Parkinson-White (WPW) Syndrome

• Wolff-Parkinson-White (WPW) Syndrome was first reported in 1930.
  • Electrically active muscle fibers bridge the atria and ventricles - and cause pre-excitation of the ventricles.
  • This accessory pathway is able to conduct faster than the AV node.
  • WPW is a reentry mechanism with an accessory pathway.
  • Can be difficult to diagnose in some children because of the higher normal sinus rates and rapid AV node conduction.
• EKG characteristics are seen only after a rhythm conversion from PSVT to NSR; see a representative tracing below.
  • PR interval is shorter
  • the upstroke of the QRS wave is slurred; this is known as a delta wave.
  • 12 lead is essential as delta wave may not show up in all leads.

• When PSVT is caused by WPW, the long term medical therapy is a beta blocker.
  • The first drug of choice is propranolol.

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WPW can be diagnosed with a 12 lead EKG while the patient is in PSVT rhythm.

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Learn more about WPW on the Web. Click here (Richard P. Abben, M.D. Cardiovascular Institute of the South)