Zespół wolffa-parkinsona-white’a (wpw)

Zespół wolffa-parkinsona-white’a (wpw)
Etiologia i przyczyny

Zespół Wolffa-Parkinsona-White’a (WPW) to wrodzony zespół preekscytacji serca, wynikający z obecności dodatkowej drogi przewodzenia elektrycznego między przedsionkami a komorami, omijającej węzeł przedsionkowo-komorowy. Ta dodatkowa droga, powstała najprawdopodobniej w wyniku nieprawidłowego rozwoju embriologicznego serca, umożliwia szybkie przewodzenie impulsów, co sprzyja powstawaniu arytmii, takich jak nawrotny częstoskurcz przedsionkowo-komorowy (AVRT) oraz migotanie przedsionków. W przebiegu migotania przedsionków impulsy mogą być przewodzone do komór z bardzo wysoką częstotliwością (350-600/min), co zwiększa ryzyko migotania komór i nagłej śmierci sercowej. Dodatkowe drogi mogą lokalizować się po prawej lub lewej stronie serca, a ich charakterystyka przewodzenia (szybkość, kierunek, okres refrakcji) determinuje ryzyko i mechanizm arytmii. W niewielkim odsetku przypadków WPW jest związany z mutacjami w genie PRKAG2, które prowadzą do kardiomiopatii przerostowej i zaburzeń przewodzenia, jednak większość przypadków ma charakter sporadyczny. WPW może współistnieć z innymi wadami wrodzonymi, np. anomalią Ebsteina, szczególnie u niemowląt (do 20% przypadków).

Diagnostyka i leczenie WPW koncentrują się na zapobieganiu epizodom tachykardii i powikłaniom zagrażającym życiu. Farmakoterapia obejmuje antyarytmiki klasy IA, IC i III (np. prokainamid, amiodaron), które spowalniają przewodzenie i wydłużają okres refrakcji dróg dodatkowych oraz węzła AV. Należy unikać digoksyny, beta-blokerów i blokerów kanału wapniowego, które mogą nasilać przewodzenie przez drogę dodatkową i zwiększać ryzyko szybkiego rytmu komór. Leczeniem z wyboru jest ablacja cewnikowa drogi dodatkowej, skuteczna i bezpieczna (ryzyko zgonu <0,1%), szczególnie u pacjentów z objawowym WPW lub wysokim ryzykiem migotania przedsionków. W rzadkich przypadkach konieczna jest operacja kardiochirurgiczna lub wszczepienie rozrusznika. U pacjentów bezobjawowych z niskim ryzykiem można rozważyć obserwację lub profilaktyczną ablację, aby zapobiec nagłej śmierci sercowej i rozwojowi arytmii. W przyszłości diagnostyka genetyczna i poradnictwo mogą wspomagać identyfikację pacjentów z rodzinnym WPW i mutacjami PRKAG2.

Etiologia zespołu Wolffa-Parkinsona-White’a (WPW)

Rozwój w okresie embrionalnym
Charakterystyka drogi dodatkowej
Genetyczne uwarunkowania

Choroby współistniejące i czynniki ryzyka
Mechanizmy arytmii w zespole WPW

Nawrotny częstoskurcz przedsionkowo-komorowy (AVRT)
Migotanie przedsionków

Konsekwencje kliniczne
Opcje terapeutyczne

Farmakoterapia
Ablacja przezskórna
Operacja chirurgiczna
Kolejne rozdziały

Etiologia zespołu Wolffa-Parkinsona-White’a (WPW)

Zespół Wolffa-Parkinsona-White’a (WPW) to wrodzony zespół preekscytacji serca, który powstaje w wyniku nieprawidłowego przewodzenia elektrycznego przez dodatkową drogę, co może prowadzić do objawowych i zagrażających życiu arytmii. Obraz WPW wynika z zespolenia preekscytacji komór poprzez dodatkową drogę i normalnego przewodzenia elektrycznego przez węzeł przedsionkowo-komorowy.¹ Dodatkowa droga przewodzenia pozwala na krążenie sygnałów elektrycznych między przedsionkami a komorami serca szybciej niż jest to normalne, powodując epizody przyspieszonego rytmu serca.²

Rozwój w okresie embrionalnym

Dodatkowa droga przewodzenia jest uważana za wynik nieprawidłowego rozwoju serca w okresie embrionalnym. Powstaje najprawdopodobniej na skutek nieprawidłowego wczesnego zaginania się przedsionków i komór podczas embriogenezy serca.³ W rezultacie elektrycznie przewodzące wiązki mięśnia sercowego naruszają normalną izolację elektryczną przedsionka i komory, tworząc dodatkową drogę.⁴ Ta dodatkowa droga jest spowodowana pasmem mięśnia sercowego, które rozwija się, gdy płód rozwija się w macicy.⁵ Podczas nieprawidłowego rozwoju serca przed urodzeniem tkanka między przedsionkami a komorami nie rozwija się w pełni, co prowadzi do powstania nieprawidłowego połączenia elektrycznego.⁶

Dodatkowa droga przewodzenia zazwyczaj łączy bezpośrednio przedsionek z komorą, omijając węzeł przedsionkowo-komorowy, który w normalnych warunkach jest najwolniej przewodzącą częścią układu elektrycznego serca.⁷ Obecność dwóch dróg (normalnej i dodatkowej) między przedsionkami a komorami stwarza ryzyko powstania „zwarcia” normalnej drogi elektrycznej, co może prowadzić do nieprawidłowo szybkiego rytmu serca (tachykardii).⁸

Charakterystyka drogi dodatkowej

Elektryczne charakterystyki przewodzenia dodatkowej drogi mogą być różne i zależą od takich czynników jak szybkość przewodzenia, kierunek przewodzenia i okres refrakcji. Te charakterystyki, wraz z lokalizacją i liczbą dróg, będą determinować, w jaki sposób droga może być zaangażowana w zapoczątkowanie lub transmisję arytmii prowadzącej do zespołu WPW.⁹ Zdolność dodatkowej drogi w WPW do przewodzenia impulsów elektrycznych z przedsionków do komór jest ważna z kilku powodów:¹⁰

Podczas normalnego rytmu zatokowego impuls elektryczny rozprzestrzeniający się przez przedsionki dociera do komór zarówno przez węzeł przedsionkowo-komorowy, jak i przez dodatkową drogę
Podczas nawrotnego częstoskurczu przedsionkowo-komorowego (AVRT) występującego w WPW, impuls elektryczny stymuluje komory wyłącznie przez dodatkową drogę (zamiast przez normalną drogę węzła przedsionkowo-komorowego)
Jeśli u pacjenta z WPW rozwinie się migotanie przedsionków – arytmia, w której przedsionki generują impulsy elektryczne z niezwykle szybką częstotliwością – te impulsy mogą również przechodzić przez dodatkową drogę i stymulować komory z niezwykle szybką częstotliwością, prowadząc do niebezpiecznie szybkiego bicia serca

¹¹

Drogi dodatkowe mogą być prawostronnie, przedwcześnie aktywujące prawą komorę, lewostronne lub lewostronne, przedwcześnie pobudzające lewą komorę. Mogą być również obecne na dolnej powierzchni serca, zlokalizowane w pobliżu przegrody międzykomorowej.¹²

Genetyczne uwarunkowania

W większości przypadków przyczyna zespołu Wolffa-Parkinsona-White’a jest nieznana. Mały odsetek wszystkich przypadków jest spowodowany wariantami (znanymi również jako mutacje) w genie PRKAG2.¹³ Naukowcy nie są pewni, w jaki sposób warianty genu PRKAG2 prowadzą do rozwoju zespołu Wolffa-Parkinsona-White’a i powiązanych nieprawidłowości serca.¹⁴

Większość przypadków zespołu Wolffa-Parkinsona-White’a występuje u osób bez widocznej historii rodzinnej tego schorzenia. Przypadki te są opisywane jako sporadyczne i nie są dziedziczone.¹⁵ Rodzinny zespół Wolffa-Parkinsona-White’a stanowi jedynie niewielki odsetek wszystkich przypadków tego schorzenia.¹⁶ Forma rodzinna jest zwykle dziedziczona jako dominująca cecha autosomalnie mendlowska.¹⁷

Pacjenci z mutacjami w podjednostce gamma 2 kinazy białkowej aktywowanej przez adenozynomonofosforan (AMP) (PRKAG2) rozwijają kardiomiopatię charakteryzującą się przerostem komór, zespołem WPW, blokiem przedsionkowo-komorowym i postępującą zwyrodnieniową chorobą układu przewodzącego.¹⁸ Niektórzy ludzie z tym schorzeniem mogą mieć mutację w genie PRKAG2.¹⁹

Choroby współistniejące i czynniki ryzyka

Zespół WPW może występować z innymi wrodzonymi wadami serca, takimi jak anomalia Ebsteina.²⁰²¹ Pacjenci z anomalią Ebsteina mogą rozwinąć zespół WPW.²² Do 20 procent niemowląt z zespołem WPW ma również chorobę serca, często jest to anomalia Ebsteina, która wpływa na zastawkę trójdzielną po prawej stronie serca.²³

Rzadko, zespół WPW jest przekazywany w rodzinach. Lekarze nazywają to dziedzicznym lub rodzinnym zespołem WPW. Jest on związany z pogrubionym mięśniem sercowym, zwanym kardiomiopatią przerostową.²⁴ Może być również związany z innymi schorzeniami kardiologicznymi, takimi jak wypadanie zastawki mitralnej, kardiomiopatia przerostowa lub inne kardiomiopatie (choroby mięśnia sercowego).²⁵

Preekscytacja może być również stworzona chirurgicznie, jak w pewnych typach modyfikacji Bjorka procedury Fontana, jeśli tkanka przedsionka jest wywinięta na tkankę komorową i przyszyta do niej. Niektóre guzy pierścienia przedsionkowo-komorowego, takie jak mięśniaki prążkowanokomórkowe, mogą również powodować preekscytację.²⁶

Czynniki ryzyka zespołu Wolffa-Parkinsona-White’a (WPW) obejmują wrodzone wady serca, schorzenia genetyczne, choroby serca, historię rodzinną, wiek i płeć.²⁷ Mężczyźni wydają się być bardziej narażeni na WPW niż kobiety.²⁸ Osoby pochodzenia chińskiego są również bardziej zagrożone.²⁹

Mechanizmy arytmii w zespole WPW

Sama obecność dodatkowej drogi nie powoduje tachykardii. Istnieją dwa mechanizmy tachykardii w zespole WPW: nawrotny częstoskurcz przedsionkowo-komorowy (AVRT) i migotanie przedsionków.³⁰

Nawrotny częstoskurcz przedsionkowo-komorowy (AVRT)

Najczęstszym mechanizmem tachykardii u osób z WPW jest tak zwany nawrotny częstoskurcz przedsionkowo-komorowy (AVRT).³¹ Obecność dwóch dróg między przedsionkami a komorami stwarza możliwość utworzenia pętli nawrotnej, gdzie impuls elektryczny krąży w kółko. Impuls może przechodzić w dół przez węzeł przedsionkowo-komorowy, a następnie wrócić do przedsionków przez dodatkową drogę (ortodromowy AVRT) lub odwrotnie (antydromowy AVRT).³²

Migotanie przedsionków

Migotanie przedsionków może być szczególnie niebezpieczne dla osób z zespołem Wolffa-Parkinsona-White’a. Dodatkowa droga może przewodzić szybkie impulsy do komór z znacznie większą szybkością niż normalna droga (przez węzeł przedsionkowo-komorowy).³³ Podczas migotania przedsionków przedsionki biją w sposób nieskoordynowany z częstotliwością od 350 do 600 uderzeń na minutę.³⁴

Jednak w przypadku WPW, przewodzenie z przedsionków do komór może być szybkie, co skutkuje większą liczbą impulsów docierających do komór przez dodatkową drogę.³⁵ W bardzo rzadkich przypadkach, jeśli serce wpadnie w szybki rytm, taki jak migotanie przedsionków lub trzepotanie, dodatkowa droga może umożliwić przewodzenie do komór w niekontrolowany, niebezpiecznie szybki sposób, z powtarzającą się stymulacją komór potencjalnie prowadzącą do migotania komór z utratą przytomności i nagłej śmierci sercowej.³⁶

Konsekwencje kliniczne

Zespół WPW może powodować następujące problemy:³⁷

Niewydolność serca
Poważne arytmie, w tym migotanie przedsionków
Zatrzymanie akcji serca, które może być śmiertelne i jest częstsze u chłopców i mężczyzn oraz u osób z innymi chorobami serca

³⁸

Główne konsekwencje to:³⁹

Zespół WPW, objawiający się napadami tachykardii, obniża jakość życia pacjentów
Częste napady choroby mogą prowadzić do bardziej niebezpiecznego i złożonego migotania przedsionków, które może przekształcić się w migotanie komór i prowadzić do śmierci

⁴⁰

Tylko jedna trzecia bezobjawowych pacjentów poniżej 40 roku życia, którzy mają zespół preekscytacji komór (fala delta) w EKG, ostatecznie rozwija objawy arytmii.⁴¹

Opcje terapeutyczne

Głównym celem leczenia zespołu WPW jest zapobieganie epizodom szybkiego rytmu serca i zmniejszenie ryzyka powikłań. Standardowe podejście obejmuje kombinację leków, zmian stylu życia i procedur takich jak ablacja lub operacja serca.⁴²

Farmakoterapia

Leki przepisywane w celu kontrolowania szybkiego rytmu serca związanego z zespołem WPW mogą obejmować leki antyarytmiczne, takie jak prokainamid lub amiodaron.⁴³ Blokery kanału sodowego (antyarytmiki klasy IA i IC) i niektóre leki antyarytmiczne klasy III są szczególnie skuteczne w spowolnieniu przewodzenia, a także w wydłużeniu okresu refrakcji dróg dodatkowych i węzła przedsionkowo-komorowego; tym samym są uważane za optymalne dla tego konkretnego schorzenia.⁴⁴

Digoksyna, beta-blokery i blokery kanału wapniowego są skuteczne w hamowaniu przewodzenia przez węzeł przedsionkowo-komorowy; jednak nie hamują przewodzenia przez większość dróg dodatkowych. Przeciwnie, leki te mogą faktycznie zmniejszyć okres refrakcji drogi dodatkowej, co może prowadzić do szybszego rytmu komór (i ryzyka załamania hemodynamicznego), jeśli zostaną podane osobom cierpiącym na zespół WPW, u których występuje trzepotanie przedsionków.⁴⁵

Ablacja przezskórna

Trwałym rozwiązaniem dla zespołu WPW jest często ablacja cewnikowa. Ablacja jest często skuteczna w leczeniu zespołu WPW i może wyeliminować potrzebę stosowania leków.⁴⁶ W przypadku schorzeń takich jak zespół Wolffa-Parkinsona-White’a, gdzie włókno cienkie jak włos tworzy dodatkową drogę elektryczną między górnymi a dolnymi komorami serca, ablacja radiofrekwencyjna oferuje wyleczenie. Stała się ona leczeniem z wyboru dla pacjentów z tym zaburzeniem, którzy nie reagują dobrze na terapię lekową lub którzy mają skłonność do szybkiego rytmu serca.⁴⁷

Ryzyko zgonu podczas zabiegu jest mniejsze niż 1 na 1000.⁴⁸ Ablacja jest preferowanym leczeniem, ponieważ migotanie przedsionków może być szczególnie niebezpieczne dla osób z zespołem WPW. Ryzyko, że ten rytm może zagrażać życiu, jest powodem, dla którego większości osób z objawowym WPW zaleca się poddanie ablacji cewnikowej.⁴⁹

Operacja chirurgiczna

W rzadkich przypadkach może być konieczna operacja na otwartym sercu w celu skorygowania dodatkowej drogi elektrycznej w sercu lub wszczepienia rozrusznika serca.⁵⁰

Zespół WPW jest w dużej mierze wrodzony lub dziedziczny. Nie istnieje konkretna metoda eliminacji możliwości rozwoju dróg dodatkowych. W przyszłości rozpoznanie genetyczne i poradnictwo może stać się użytecznym narzędziem.⁵¹

Bezobjawowi pacjenci, którzy mają drogę o niskim ryzyku i nie mają częstoskurczu nadkomorowego, mogą być monitorowani oczekująco, lub mogą poddać się ablacji RF, aby zapobiec wszelkim możliwościom nagłej śmierci sercowej i zapobiec późnemu wystąpieniu częstoskurczu nadkomorowego.⁵² Ponadto istnieje związany wzrost częstości występowania migotania przedsionków u pacjentów z WPW, który może być zmniejszony poprzez profilaktyczną ablację RF drogi dodatkowej.⁵³

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Materiały źródłowe

#1 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK554437/
Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway that can result in symptomatic and life-threatening arrhythmias. […] WPW pattern arises from the fusion of ventricular preexcitation through the accessory pathway and normal electrical conduction through the AV node. This accessory pathway is thought to arise from chamber myocardium during improper early atrial and ventricular folding in cardiac embryogenesis. As a result, electrically conductive myocardial bundles violate the normal electrical insulation of the atrium and ventricle, forming the accessory pathway. […] The electrical conducting characteristics of the accessory pathway can vary and depend upon factors such as the speed of conduction, direction of conduction, and refractory period. These characteristics, along with location and number of pathways, will determine how the pathway may be involved in the initiation or transmission of an arrhythmia leading to WPW syndrome.
#2 Wolff-Parkinson-White Syndrome
https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw
Wolff-Parkinson-White syndrome (WPW) is a heart condition that occurs in people born with an extra electrical pathway for heartbeat signals. When electrical impulses or signals take this extra route instead of the usual one, they travel through your heart too quickly. This causes your heart to beat rapidly, a type of abnormal heart rhythm that healthcare providers call supraventricular tachycardia (SVT). […] Healthcare providers usually dont know the cause of Wolff-Parkinson-White syndrome. There may be a history of WPW syndrome in your family, or you may develop the condition due to an unknown cause. […] Researchers arent sure whether parents pass Wolff-Parkinson-White syndrome to their children. Most people with WPW dont have parents who have the disease, but you can inherit some genes that lead to WPW syndrome. These inherited cases are called familial Wolff-Parkinson-White syndrome. […] Wolff-Parkinson-White syndrome is a condition youre born with. Theres nothing you can do to prevent it.
#3 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK554437/
Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway that can result in symptomatic and life-threatening arrhythmias. […] WPW pattern arises from the fusion of ventricular preexcitation through the accessory pathway and normal electrical conduction through the AV node. This accessory pathway is thought to arise from chamber myocardium during improper early atrial and ventricular folding in cardiac embryogenesis. As a result, electrically conductive myocardial bundles violate the normal electrical insulation of the atrium and ventricle, forming the accessory pathway. […] The electrical conducting characteristics of the accessory pathway can vary and depend upon factors such as the speed of conduction, direction of conduction, and refractory period. These characteristics, along with location and number of pathways, will determine how the pathway may be involved in the initiation or transmission of an arrhythmia leading to WPW syndrome.
#4 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK554437/
Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway that can result in symptomatic and life-threatening arrhythmias. […] WPW pattern arises from the fusion of ventricular preexcitation through the accessory pathway and normal electrical conduction through the AV node. This accessory pathway is thought to arise from chamber myocardium during improper early atrial and ventricular folding in cardiac embryogenesis. As a result, electrically conductive myocardial bundles violate the normal electrical insulation of the atrium and ventricle, forming the accessory pathway. […] The electrical conducting characteristics of the accessory pathway can vary and depend upon factors such as the speed of conduction, direction of conduction, and refractory period. These characteristics, along with location and number of pathways, will determine how the pathway may be involved in the initiation or transmission of an arrhythmia leading to WPW syndrome.
#5 Wolff-Parkinson-White syndrome
https://www.nhs.uk/conditions/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White (WPW) syndrome is a condition that causes the heart to beat abnormally fast for periods of time. […] The cause is an extra electrical connection in the heart. This problem with the heart is present at birth (congenital), although symptoms may not develop until later in life. […] The extra electrical connection is caused by a strand of heart muscle that grows while the unborn baby is developing in the womb. […] It’s not clear exactly why this happens. It just seems to occur randomly in some babies, although rare cases have been found to run in families.
#6 What Is Wolff-Parkinson-White Syndrome?
https://www.icliniq.com/articles/heart-circulatory-health/wolff-parkinson-white-syndrome
Wolff-Parkinson-White Syndrome (WPW) is a heart condition that affects the heart’s electrical system. It is caused by abnormal development of the heart’s electrical system during fetal development. WPW Syndrome is a congenital heart condition, which means that it is present at birth. An additional pathway, known as the accessory pathway, is formed when the tissue between the atria and ventricles fails to develop fully, resulting in an abnormal electrical connection. Although the exact cause of this abnormal development is unknown, researchers believe it may be the result of genetic mutations affecting the heart’s electrical system during fetal development. Environmental factors such as fetal drug, toxin, or virus exposure may also contribute to developing WPW. […] WPW Syndrome may be associated with other heart conditions, such as congenital heart defects or hypertrophic cardiomyopathy in some cases.
#7 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
Wolff-Parkinson-White (WPW) syndrome is a condition in which episodes of fast heart rate (called tachycardia) occur because of an abnormal extra electrical pathway in the heart. […] People with WPW syndrome have an extra electrical pathway between the atria and the ventricles, known as an accessory pathway. The abnormal pathway directly connects the atria and ventricles and bypasses the AV node, which is the slowest conducting part of the heart’s electrical system. […] The presence of two pathways (the normal one and the accessory one) between the atria and ventricles poses a risk of developing a „short circuit” of the normal electrical pathway, which can result in an abnormally fast heart rate (tachycardia). […] The presence of an accessory pathway alone does not cause tachycardia. There are two mechanisms of tachycardia in the WPW syndrome: Atrioventricular reentrant tachycardia (AVRT) and Atrial fibrillation.
#8 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
Wolff-Parkinson-White (WPW) syndrome is a condition in which episodes of fast heart rate (called tachycardia) occur because of an abnormal extra electrical pathway in the heart. […] People with WPW syndrome have an extra electrical pathway between the atria and the ventricles, known as an accessory pathway. The abnormal pathway directly connects the atria and ventricles and bypasses the AV node, which is the slowest conducting part of the heart’s electrical system. […] The presence of two pathways (the normal one and the accessory one) between the atria and ventricles poses a risk of developing a „short circuit” of the normal electrical pathway, which can result in an abnormally fast heart rate (tachycardia). […] The presence of an accessory pathway alone does not cause tachycardia. There are two mechanisms of tachycardia in the WPW syndrome: Atrioventricular reentrant tachycardia (AVRT) and Atrial fibrillation.
#9 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK554437/
Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway that can result in symptomatic and life-threatening arrhythmias. […] WPW pattern arises from the fusion of ventricular preexcitation through the accessory pathway and normal electrical conduction through the AV node. This accessory pathway is thought to arise from chamber myocardium during improper early atrial and ventricular folding in cardiac embryogenesis. As a result, electrically conductive myocardial bundles violate the normal electrical insulation of the atrium and ventricle, forming the accessory pathway. […] The electrical conducting characteristics of the accessory pathway can vary and depend upon factors such as the speed of conduction, direction of conduction, and refractory period. These characteristics, along with location and number of pathways, will determine how the pathway may be involved in the initiation or transmission of an arrhythmia leading to WPW syndrome.
#10 Wolff-Parkinson-White Syndrome – WPW
https://www.verywellhealth.com/wolff-parkinson-white-syndrome-wpw-1746260
First, during normal sinus rhythm, the electrical impulse spreading across the atria reaches the ventricles both through the AV node and through the accessory pathway. […] Second, during the AVRT seen with WPW, the electrical impulse is stimulating the ventricles solely through the accessory pathway (instead of going through the normal, AV nodal pathway). […] Third, if a patient with WPW should develop atrial fibrillation an arrhythmia in which the atria are generating electrical impulses at an extremely rapid rate those impulses can also travel down the accessory pathway and stimulate the ventricles at an also extremely rapid rate, leading to a dangerously fast heartbeat. […] In very rare cases if the heart goes into a rapid rhythm like atrial fibrillation or flutter an accessory pathway may allow conduction to the ventricles in an uncontrolled, dangerously fast rate, with repetitive stimulation of the ventricles potentially leading to ventricular fibrillation with loss of consciousness and sudden cardiac death.
#11 Wolff-Parkinson-White Syndrome – WPW
https://www.verywellhealth.com/wolff-parkinson-white-syndrome-wpw-1746260
First, during normal sinus rhythm, the electrical impulse spreading across the atria reaches the ventricles both through the AV node and through the accessory pathway. […] Second, during the AVRT seen with WPW, the electrical impulse is stimulating the ventricles solely through the accessory pathway (instead of going through the normal, AV nodal pathway). […] Third, if a patient with WPW should develop atrial fibrillation an arrhythmia in which the atria are generating electrical impulses at an extremely rapid rate those impulses can also travel down the accessory pathway and stimulate the ventricles at an also extremely rapid rate, leading to a dangerously fast heartbeat. […] In very rare cases if the heart goes into a rapid rhythm like atrial fibrillation or flutter an accessory pathway may allow conduction to the ventricles in an uncontrolled, dangerously fast rate, with repetitive stimulation of the ventricles potentially leading to ventricular fibrillation with loss of consciousness and sudden cardiac death.
#12 Wolff-Parkinson-White syndrome | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/wolff-parkinson-white-syndrome-2
Accessory pathways may be right-sided, prematurely activating the right ventricle, left-sided or left-sided, pre-exciting the left ventricle. They may also be present on the inferior surface of the heart, located near the interventricular septum. […] The presence of re-entry through an accessory pathway (with fast retrograde conduction and slow antegrade conduction) is considered a likely etiology when the VA interval is shorter than the AV interval in the presence of a fetal SVT; this may affect choice of therapy and prognosis.
#13 Wolff-Parkinson-White syndrome: MedlinePlus GeneticsLock
https://medlineplus.gov/genetics/condition/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart’s normal rhythm (arrhythmia). […] People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. […] In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. A small percentage of all cases are caused by variants (also known as mutations) in the PRKAG2 gene. […] Researchers are uncertain how PRKAG2 gene variants lead to the development of Wolff-Parkinson-White syndrome and related heart abnormalities. […] Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition. These cases are described as sporadic and are not inherited. […] Familial Wolff-Parkinson-White syndrome accounts for only a small percentage of all cases of this condition.
#14 Wolff-Parkinson-White syndrome: MedlinePlus GeneticsLock
https://medlineplus.gov/genetics/condition/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart’s normal rhythm (arrhythmia). […] People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. […] In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. A small percentage of all cases are caused by variants (also known as mutations) in the PRKAG2 gene. […] Researchers are uncertain how PRKAG2 gene variants lead to the development of Wolff-Parkinson-White syndrome and related heart abnormalities. […] Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition. These cases are described as sporadic and are not inherited. […] Familial Wolff-Parkinson-White syndrome accounts for only a small percentage of all cases of this condition.
#15 Wolff-Parkinson-White syndrome: MedlinePlus GeneticsLock
https://medlineplus.gov/genetics/condition/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart’s normal rhythm (arrhythmia). […] People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. […] In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. A small percentage of all cases are caused by variants (also known as mutations) in the PRKAG2 gene. […] Researchers are uncertain how PRKAG2 gene variants lead to the development of Wolff-Parkinson-White syndrome and related heart abnormalities. […] Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition. These cases are described as sporadic and are not inherited. […] Familial Wolff-Parkinson-White syndrome accounts for only a small percentage of all cases of this condition.
#16 Wolff-Parkinson-White syndrome: MedlinePlus GeneticsLock
https://medlineplus.gov/genetics/condition/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart’s normal rhythm (arrhythmia). […] People with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. […] In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. A small percentage of all cases are caused by variants (also known as mutations) in the PRKAG2 gene. […] Researchers are uncertain how PRKAG2 gene variants lead to the development of Wolff-Parkinson-White syndrome and related heart abnormalities. […] Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition. These cases are described as sporadic and are not inherited. […] Familial Wolff-Parkinson-White syndrome accounts for only a small percentage of all cases of this condition.
#17 Wolff-Parkinson-White Syndrome: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/159222-overview
APs are considered congenital phenomena that are related to a failure of insulating tissue maturation within the AV ringeven though their manifestations are often detected in later years, making them appear to be „acquired.” […] Family studies, as well as molecular genetic investigations, indicate that WPW syndrome, along with associated preexcitation disorders, may have a genetic component. It may be inherited as a familial trait, with or without associated congenital heart defects (CHDs) […] The familial form is usually inherited as a mendelian autosomal dominant trait. […] Patients with mutations in the gamma 2 subunit of adenosine monophosphate (AMP)-activated protein kinase (PRKAG2) develop cardiomyopathy characterized by ventricular hypertrophy, WPW syndrome, AV block, and progressive degenerative conduction system disease.
#18 Wolff-Parkinson-White Syndrome: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/159222-overview
APs are considered congenital phenomena that are related to a failure of insulating tissue maturation within the AV ringeven though their manifestations are often detected in later years, making them appear to be „acquired.” […] Family studies, as well as molecular genetic investigations, indicate that WPW syndrome, along with associated preexcitation disorders, may have a genetic component. It may be inherited as a familial trait, with or without associated congenital heart defects (CHDs) […] The familial form is usually inherited as a mendelian autosomal dominant trait. […] Patients with mutations in the gamma 2 subunit of adenosine monophosphate (AMP)-activated protein kinase (PRKAG2) develop cardiomyopathy characterized by ventricular hypertrophy, WPW syndrome, AV block, and progressive degenerative conduction system disease.
#19 Wolff-Parkinson-White Syndrome: Symptoms, Treatment, More
https://www.healthline.com/health/arrhythmia/wolff-parkinson-white-syndrome
Wolff-Parkinson-White syndrome is a type of congenital heart arrhythmia. […] WPW syndrome occurs when youre born with an additional electrical current in your heart called an accessory pathway. This is caused by an extra strand of heart muscle tissue that grows during fetal development. […] WPW syndrome is a common cause of a type of heart arrhythmia called paroxysmal supraventricular tachycardia. Its a type of fast heart rhythm that comes and goes. […] In most cases, WPW syndrome develops at random during fetal development. […] Some people with this condition may have a mutation in their PRKAG2 gene. […] WPW syndrome may be mild enough to not require treatment, but it wont go away without medical treatment. Catheter ablation is the only possible cure for WPW syndrome.
#20 WPW syndrome: Rare cause of sudden cardiac death in young people – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/wolff-parkinson-white-syndrome/symptoms-causes/syc-20354626
Wolff-Parkinson-White (WPW) syndrome is a heart condition present at birth. That means it’s a congenital heart defect. People with WPW syndrome have an extra pathway for signals to travel between the heart’s upper and lower chambers. This causes a fast heartbeat. […] Researchers aren’t sure what causes most types of congenital heart defects. WPW syndrome may occur with other congenital heart defects, such as Ebstein anomaly. […] Rarely, WPW syndrome is passed down through families. Your healthcare team may call this inherited or familial WPW syndrome. It is associated with a thickened heart muscle, called hypertrophic cardiomyopathy.
#21 Wolff-Parkinson-White Syndrome (WPW) – UF Health
https://ufhealth.org/conditions-and-treatments/wolff-parkinson-white-syndrome-wpw
Wolff-Parkinson-White (WPW) syndrome is a condition in which there is an extra electrical pathway in the heart that leads to periods of rapid heart rate (tachycardia). […] WPW syndrome is one of the most common causes of fast heart rate problems in infants and children. […] In people with WPW syndrome, some of the heart’s electrical signals go down an extra pathway. This may cause a very rapid heart rate called supraventricular tachycardia. […] However, this condition has been linked with other cardiac conditions, such as Ebstein anomaly. A form of the condition also runs in families.
#22 Wolff-Parkinson-White Syndrome: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/159222-overview
Patients with the Ebstein anomaly may develop WPW syndrome. […] Preexcitation can be surgically created, as in certain types of Bjork modifications of the Fontan procedure, if atrial tissue is flapped onto and sutured to ventricular tissue. Certain tumors of the AV ring, such as rhabdomyomas, may also cause preexcitation.
#23 Wolff-Parkinson-White syndrome: Causes, symptoms, and treatment
https://www.medicalnewstoday.com/articles/220163
Wolff-Parkinson-White syndrome occurs when there is a problem with the electrical pathway between one of the upper chambers of the heart, or atria, and one of the lower chambers, or ventricles. […] A person who has Wolff-Parkinson-White (WPW) syndrome is born with the extra electrical pathway that affects the beat of their heart. […] It is unclear exactly why this extra electrical pathway develops, but a small percentage of people with WPW syndrome have a genetic mutation. Others are born with a heart defect. […] Up to 20 percent of infants with WPW syndrome also have a heart disease, and this is often Ebsteins anomaly that affects the tricuspid valve on the right side of the heart.
#24 WPW syndrome: Rare cause of sudden cardiac death in young people – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/wolff-parkinson-white-syndrome/symptoms-causes/syc-20354626
Wolff-Parkinson-White (WPW) syndrome is a heart condition present at birth. That means it’s a congenital heart defect. People with WPW syndrome have an extra pathway for signals to travel between the heart’s upper and lower chambers. This causes a fast heartbeat. […] Researchers aren’t sure what causes most types of congenital heart defects. WPW syndrome may occur with other congenital heart defects, such as Ebstein anomaly. […] Rarely, WPW syndrome is passed down through families. Your healthcare team may call this inherited or familial WPW syndrome. It is associated with a thickened heart muscle, called hypertrophic cardiomyopathy.
#25 Wolff-Parkinson-White Syndrome | Memorial Hermann
https://memorialhermann.org/services/conditions/wolff-parkinson-white-syndrome
Wolff-Parkinson-White Syndrome (WPW) is a congenital heart abnormality; the extra electrical pathway is present at birth. […] WPW occurs randomly in the general population, in about 1 to 3 of 1,000 persons. […] Some cases of WPW are inherited. […] WPW may be associated with congenital cardiac defects, Ebstein’s anomaly, mitral valve prolapse, hypertrophic cardiomyopathy or other cardiomyopathies (diseases of the heart muscle).
#26 Wolff-Parkinson-White Syndrome: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/159222-overview
Patients with the Ebstein anomaly may develop WPW syndrome. […] Preexcitation can be surgically created, as in certain types of Bjork modifications of the Fontan procedure, if atrial tissue is flapped onto and sutured to ventricular tissue. Certain tumors of the AV ring, such as rhabdomyomas, may also cause preexcitation.
#27 WOLFF-PARKINSON-WHITE SYNDROME: CAUSES, COMPLICATIONS, ABLATION, AND MANAGEMENT | Mya Care
https://myacare.com/blog/wolff-parkinson-white-syndrome-causes-complications-ablation-and-management
Wolff-Parkinson-White syndrome (WPW) is a rare heart condition that affects approximately 1-3 people out of every 1,000. […] WPW syndrome, sometimes known as pre-excitation syndrome, is a congenital heart defect, meaning it is present at birth. It occurs when there is an extra electrical route between the heart’s atria (upper section) and ventricles (lower section). This extra pathway is known as an accessory pathway, while the standard pathway is known as the AV node. […] The exact cause of the accessory pathway has yet to be fully understood. It is likely the result of abnormal development of the heart during fetal development. […] Risk factors of Wolff-Parkinson-White syndrome (WPW) include congenital heart defects, genetic conditions, heart conditions, family history, age, and gender.
#28 Wolff-Parkinson-White syndrome – Pediatric Cardiology | Northwell Health
https://pediatrics.northwell.edu/departments-services/pediatric-cardiology/find-care/conditions/wolff-parkinson-white-syndrome
Wolff-Parkinson-White (WPW) syndrome is associated with several types of arrhythmias (electrical problems of the heart), including supraventricular tachycardia (SVT) and pre-excited atrial fibrillation, conditions in which the heart beats abnormally fast. […] WPW is a congenital electrical abnormality of the heart. It occurs in about 1 in 1,000 patients, and has no known cause in most cases. However, males seem to be at a higher risk of WPW than females, and rare cases seem to be inherited.
#29 Wolff-Parkinson-White Syndrome | UCI Health | Orange County, CA
https://www.ucihealth.org/medical-services/conditions/Wolff-Parkinson-White
People with WPW syndrome are born with an extra electrical pathway in the heart. […] We dont know the exact cause of WPW, but researchers have identified a gene mutation that may be responsible. People of Chinese descent are also at greater risk.
#30 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
Wolff-Parkinson-White (WPW) syndrome is a condition in which episodes of fast heart rate (called tachycardia) occur because of an abnormal extra electrical pathway in the heart. […] People with WPW syndrome have an extra electrical pathway between the atria and the ventricles, known as an accessory pathway. The abnormal pathway directly connects the atria and ventricles and bypasses the AV node, which is the slowest conducting part of the heart’s electrical system. […] The presence of two pathways (the normal one and the accessory one) between the atria and ventricles poses a risk of developing a „short circuit” of the normal electrical pathway, which can result in an abnormally fast heart rate (tachycardia). […] The presence of an accessory pathway alone does not cause tachycardia. There are two mechanisms of tachycardia in the WPW syndrome: Atrioventricular reentrant tachycardia (AVRT) and Atrial fibrillation.
#31 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
Wolff-Parkinson-White (WPW) syndrome is a condition in which episodes of fast heart rate (called tachycardia) occur because of an abnormal extra electrical pathway in the heart. […] People with WPW syndrome have an extra electrical pathway between the atria and the ventricles, known as an accessory pathway. The abnormal pathway directly connects the atria and ventricles and bypasses the AV node, which is the slowest conducting part of the heart’s electrical system. […] The presence of two pathways (the normal one and the accessory one) between the atria and ventricles poses a risk of developing a „short circuit” of the normal electrical pathway, which can result in an abnormally fast heart rate (tachycardia). […] The presence of an accessory pathway alone does not cause tachycardia. There are two mechanisms of tachycardia in the WPW syndrome: Atrioventricular reentrant tachycardia (AVRT) and Atrial fibrillation.
#32 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics
Wolff-Parkinson-White (WPW) syndrome is a condition in which episodes of fast heart rate (called tachycardia) occur because of an abnormal extra electrical pathway in the heart. […] People with WPW syndrome have an extra electrical pathway between the atria and the ventricles, known as an „accessory pathway.” This abnormal pathway directly connects the atria and ventricles at a site other than the AV node. […] The presence of two pathways (the normal one and the accessory one) between the atria and ventricles poses a risk of developing a „short circuit” of the normal electrical pathway, which can result in an abnormally fast heart rate (tachycardia). […] The presence of an accessory pathway alone does not cause tachycardia. There are two mechanisms of tachycardia in the WPW syndrome: Atrioventricular reentrant tachycardia (AVRT) and Atrial fibrillation. […] The most common mechanism of tachycardia in people with WPW is called atrioventricular reentrant tachycardia (AVRT). […] Less commonly, some people with WPW can develop an abnormal rhythm called atrial fibrillation.
#33 Wolff-Parkinson-White (WPW) Syndrome – Heart and Blood Vessel Disorders – Merck Manual Consumer Version
https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/abnormal-heart-rhythms/wolff-parkinson-white-wpw-syndrome
Wolff-Parkinson-White syndrome is a disorder in which an extra electrical connection between the atria and the ventricles is present at birth. […] The abnormal pathway that causes Wolff-Parkinson-White syndrome is present at birth, but the arrhythmias it causes usually become apparent only during the teens or early twenties. […] Wolff-Parkinson-White syndrome is the most common of several disorders that involve an extra (accessory) electrical pathway between the atria and the ventricles. This extra pathway makes fast abnormal heart rhythms (arrhythmias) more likely to occur. […] Atrial fibrillation may be particularly dangerous for people with Wolff-Parkinson-White syndrome. The extra pathway can conduct the rapid impulses to the ventricles at a much faster rate than the normal pathway (through the atrioventricular node) can. […] The risk of death during the procedure is less than 1 in 1,000.
#34 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
The most common mechanism of tachycardia in people with WPW is called atrioventricular reentrant tachycardia (AVRT). […] During atrial fibrillation, the atria are beating in an uncoordinated manner at a rate of 350 to 600 beats per minute. […] However, with WPW, conduction from the atria to the ventricles can be rapid, resulting in more impulses getting to the ventricles by crossing the accessory pathway. […] The risk that this rhythm can be life threatening is why most people with symptomatic WPW are advised to undergo catheter ablation.
#35 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
The most common mechanism of tachycardia in people with WPW is called atrioventricular reentrant tachycardia (AVRT). […] During atrial fibrillation, the atria are beating in an uncoordinated manner at a rate of 350 to 600 beats per minute. […] However, with WPW, conduction from the atria to the ventricles can be rapid, resulting in more impulses getting to the ventricles by crossing the accessory pathway. […] The risk that this rhythm can be life threatening is why most people with symptomatic WPW are advised to undergo catheter ablation.
#36 Wolff-Parkinson-White Syndrome – WPW
https://www.verywellhealth.com/wolff-parkinson-white-syndrome-wpw-1746260
First, during normal sinus rhythm, the electrical impulse spreading across the atria reaches the ventricles both through the AV node and through the accessory pathway. […] Second, during the AVRT seen with WPW, the electrical impulse is stimulating the ventricles solely through the accessory pathway (instead of going through the normal, AV nodal pathway). […] Third, if a patient with WPW should develop atrial fibrillation an arrhythmia in which the atria are generating electrical impulses at an extremely rapid rate those impulses can also travel down the accessory pathway and stimulate the ventricles at an also extremely rapid rate, leading to a dangerously fast heartbeat. […] In very rare cases if the heart goes into a rapid rhythm like atrial fibrillation or flutter an accessory pathway may allow conduction to the ventricles in an uncontrolled, dangerously fast rate, with repetitive stimulation of the ventricles potentially leading to ventricular fibrillation with loss of consciousness and sudden cardiac death.
#37 Arrhythmias – Wolff-Parkinson-White Syndrome | NHLBI, NIH
https://www.nhlbi.nih.gov/health/wolff-parkinson-white-syndrome
Wolff-Parkinson-White (WPW) syndrome is a conduction disorder that can make your heart beat too quickly or with an irregular rhythm. This is called an arrhythmia, and it can be life-threatening. […] WPW syndrome is a congenital condition, which means that you are born with it. It is caused by problems with how your heart develops before birth. This condition can be inherited. You have a higher risk of having WPW syndrome if you have a close relative with this condition. […] If left untreated, WPW syndrome can cause the following problems: Heart failure, Serious arrhythmias, including atrial fibrillation, Cardiac arrest, which can be fatal and is more common in boys and men and in people who have other heart conditions.
#38 Arrhythmias – Wolff-Parkinson-White Syndrome | NHLBI, NIH
https://www.nhlbi.nih.gov/health/wolff-parkinson-white-syndrome
Wolff-Parkinson-White (WPW) syndrome is a conduction disorder that can make your heart beat too quickly or with an irregular rhythm. This is called an arrhythmia, and it can be life-threatening. […] WPW syndrome is a congenital condition, which means that you are born with it. It is caused by problems with how your heart develops before birth. This condition can be inherited. You have a higher risk of having WPW syndrome if you have a close relative with this condition. […] If left untreated, WPW syndrome can cause the following problems: Heart failure, Serious arrhythmias, including atrial fibrillation, Cardiac arrest, which can be fatal and is more common in boys and men and in people who have other heart conditions.
#39 Wolff-Parkinson-White (WPW) Syndrome: Symptoms and Causes
https://lonestarneurology.net/blog/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a violation of the process of excitation of the ventricles, in which there is an increase in the heart rate. […] With this pathology, secondary conduction pathways are formed, called the Kent beam, which is characterized by different electrophysiological properties and therefore conducts excitation faster. […] Possible and predisposing causes: congenital valvular defects (mitral valve prolapse, tricuspid valve prolapse, accessory chords, open foramen ovale); hereditary predisposition; systemic connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome). […] Only one-third of asymptomatic patients under the age of 40 who have ventricular preexcitation syndrome (delta wave) on the ECG eventually develop signs of arrhythmia. […] The main consequences are: The WPW syndrome, manifested by attacks of tachycardia, reduces the patients quality of life. […] Frequent attacks of the disease can lead to more dangerous and complex atrial fibrillation, which can transform into ventricular fibrillation and lead to death.
#40 Wolff-Parkinson-White (WPW) Syndrome: Symptoms and Causes
https://lonestarneurology.net/blog/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a violation of the process of excitation of the ventricles, in which there is an increase in the heart rate. […] With this pathology, secondary conduction pathways are formed, called the Kent beam, which is characterized by different electrophysiological properties and therefore conducts excitation faster. […] Possible and predisposing causes: congenital valvular defects (mitral valve prolapse, tricuspid valve prolapse, accessory chords, open foramen ovale); hereditary predisposition; systemic connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome). […] Only one-third of asymptomatic patients under the age of 40 who have ventricular preexcitation syndrome (delta wave) on the ECG eventually develop signs of arrhythmia. […] The main consequences are: The WPW syndrome, manifested by attacks of tachycardia, reduces the patients quality of life. […] Frequent attacks of the disease can lead to more dangerous and complex atrial fibrillation, which can transform into ventricular fibrillation and lead to death.
#41 Wolff-Parkinson-White (WPW) Syndrome: Symptoms and Causes
https://lonestarneurology.net/blog/wolff-parkinson-white-syndrome/
Wolff-Parkinson-White syndrome is a violation of the process of excitation of the ventricles, in which there is an increase in the heart rate. […] With this pathology, secondary conduction pathways are formed, called the Kent beam, which is characterized by different electrophysiological properties and therefore conducts excitation faster. […] Possible and predisposing causes: congenital valvular defects (mitral valve prolapse, tricuspid valve prolapse, accessory chords, open foramen ovale); hereditary predisposition; systemic connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome). […] Only one-third of asymptomatic patients under the age of 40 who have ventricular preexcitation syndrome (delta wave) on the ECG eventually develop signs of arrhythmia. […] The main consequences are: The WPW syndrome, manifested by attacks of tachycardia, reduces the patients quality of life. […] Frequent attacks of the disease can lead to more dangerous and complex atrial fibrillation, which can transform into ventricular fibrillation and lead to death.
#42 WOLFF-PARKINSON-WHITE SYNDROME: CAUSES, COMPLICATIONS, ABLATION, AND MANAGEMENT | Mya Care
https://myacare.com/blog/wolff-parkinson-white-syndrome-causes-complications-ablation-and-management
WPW syndrome is often associated with other congenital heart defects, such as Ebstein anomaly. […] The main goal of WPW syndrome treatment is to prevent episodes of rapid heart rate and reduce the risk of complications. The standard approach involves a combination of medication, lifestyle changes, and procedures such as ablation or heart surgery. […] Medications prescribed to help control the rapid heart rate associated with WPW syndrome may include anti-arrhythmic drugs, like procainamide or amiodarone. […] The enduring solution for WPW syndrome often involves catheter ablation. Ablation is often successful in treating WPW syndrome and can eliminate the need for medication. […] In rare cases, open-heart surgery may be necessary to correct the extra electrical pathway in the heart or to insert a pacemaker.
#43 WOLFF-PARKINSON-WHITE SYNDROME: CAUSES, COMPLICATIONS, ABLATION, AND MANAGEMENT | Mya Care
https://myacare.com/blog/wolff-parkinson-white-syndrome-causes-complications-ablation-and-management
WPW syndrome is often associated with other congenital heart defects, such as Ebstein anomaly. […] The main goal of WPW syndrome treatment is to prevent episodes of rapid heart rate and reduce the risk of complications. The standard approach involves a combination of medication, lifestyle changes, and procedures such as ablation or heart surgery. […] Medications prescribed to help control the rapid heart rate associated with WPW syndrome may include anti-arrhythmic drugs, like procainamide or amiodarone. […] The enduring solution for WPW syndrome often involves catheter ablation. Ablation is often successful in treating WPW syndrome and can eliminate the need for medication. […] In rare cases, open-heart surgery may be necessary to correct the extra electrical pathway in the heart or to insert a pacemaker.
#44 Wolff Parkinson White Syndrome – The Cardiology Advisor
https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/
Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter. […] Patients with WPW syndrome, a condition characterized by ventricular preexcitation, may experience atrial impulses that travel in an anterograde direction to the ventricles via both the AV node and an accessory pathway.
#45 Wolff Parkinson White Syndrome – The Cardiology Advisor
https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/
Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter. […] Patients with WPW syndrome, a condition characterized by ventricular preexcitation, may experience atrial impulses that travel in an anterograde direction to the ventricles via both the AV node and an accessory pathway.
#46 WOLFF-PARKINSON-WHITE SYNDROME: CAUSES, COMPLICATIONS, ABLATION, AND MANAGEMENT | Mya Care
https://myacare.com/blog/wolff-parkinson-white-syndrome-causes-complications-ablation-and-management
WPW syndrome is often associated with other congenital heart defects, such as Ebstein anomaly. […] The main goal of WPW syndrome treatment is to prevent episodes of rapid heart rate and reduce the risk of complications. The standard approach involves a combination of medication, lifestyle changes, and procedures such as ablation or heart surgery. […] Medications prescribed to help control the rapid heart rate associated with WPW syndrome may include anti-arrhythmic drugs, like procainamide or amiodarone. […] The enduring solution for WPW syndrome often involves catheter ablation. Ablation is often successful in treating WPW syndrome and can eliminate the need for medication. […] In rare cases, open-heart surgery may be necessary to correct the extra electrical pathway in the heart or to insert a pacemaker.
#47 Wolff-Parkinson-White Syndrome | Conditions | UCSF Health
https://www.ucsfhealth.org/conditions/wolff-parkinson-white-syndrome
With Wolff-Parkinson-White (WPW) syndrome, an extra, abnormal pathway is present between the atrium, or upper chamber, and ventricle, or lower chamber. This causes the electrical signal to arrive at the ventricle too soon and to be transmitted back into the atrium. Very fast heart rates may develop as the electrical signal ricochets between the atria and ventricles. […] For conditions like Wolff-Parkinson-White syndrome, in which a hair-thin strand of tissue creates an extra electrical pathway between the upper and lower chambers of the heart, radiofrequency ablation offers a cure. It has become the treatment of choice for patients with that disorder who don’t respond well to drug therapy or who have a propensity for rapid heart rates.
#48 Wolff-Parkinson-White (WPW) Syndrome – Heart and Blood Vessel Disorders – Merck Manual Consumer Version
https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/abnormal-heart-rhythms/wolff-parkinson-white-wpw-syndrome
Wolff-Parkinson-White syndrome is a disorder in which an extra electrical connection between the atria and the ventricles is present at birth. […] The abnormal pathway that causes Wolff-Parkinson-White syndrome is present at birth, but the arrhythmias it causes usually become apparent only during the teens or early twenties. […] Wolff-Parkinson-White syndrome is the most common of several disorders that involve an extra (accessory) electrical pathway between the atria and the ventricles. This extra pathway makes fast abnormal heart rhythms (arrhythmias) more likely to occur. […] Atrial fibrillation may be particularly dangerous for people with Wolff-Parkinson-White syndrome. The extra pathway can conduct the rapid impulses to the ventricles at a much faster rate than the normal pathway (through the atrioventricular node) can. […] The risk of death during the procedure is less than 1 in 1,000.
#49 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics/print
The most common mechanism of tachycardia in people with WPW is called atrioventricular reentrant tachycardia (AVRT). […] During atrial fibrillation, the atria are beating in an uncoordinated manner at a rate of 350 to 600 beats per minute. […] However, with WPW, conduction from the atria to the ventricles can be rapid, resulting in more impulses getting to the ventricles by crossing the accessory pathway. […] The risk that this rhythm can be life threatening is why most people with symptomatic WPW are advised to undergo catheter ablation.
#50 WOLFF-PARKINSON-WHITE SYNDROME: CAUSES, COMPLICATIONS, ABLATION, AND MANAGEMENT | Mya Care
https://myacare.com/blog/wolff-parkinson-white-syndrome-causes-complications-ablation-and-management
WPW syndrome is often associated with other congenital heart defects, such as Ebstein anomaly. […] The main goal of WPW syndrome treatment is to prevent episodes of rapid heart rate and reduce the risk of complications. The standard approach involves a combination of medication, lifestyle changes, and procedures such as ablation or heart surgery. […] Medications prescribed to help control the rapid heart rate associated with WPW syndrome may include anti-arrhythmic drugs, like procainamide or amiodarone. […] The enduring solution for WPW syndrome often involves catheter ablation. Ablation is often successful in treating WPW syndrome and can eliminate the need for medication. […] In rare cases, open-heart surgery may be necessary to correct the extra electrical pathway in the heart or to insert a pacemaker.
#51 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy
https://emedicine.medscape.com/article/159222-treatment
WPW syndrome is largely congenital or hereditary. […] No particular method exists to eliminate the possibility of developing APs. […] In the future, genetic recognition and counseling may become a useful tool. […] Asymptomatic patients who have a low-risk pathway and no SVT can be monitored expectantly, or they may undergo RF ablation to prevent any possibilities of SCD and prevent late onset of SVT. […] In addition, there is an associated rise in incidence of atrial fibrillation in patients with WPW which may be reduced with prophylactic RF ablation of the accessory pathway.
#52 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy
https://emedicine.medscape.com/article/159222-treatment
WPW syndrome is largely congenital or hereditary. […] No particular method exists to eliminate the possibility of developing APs. […] In the future, genetic recognition and counseling may become a useful tool. […] Asymptomatic patients who have a low-risk pathway and no SVT can be monitored expectantly, or they may undergo RF ablation to prevent any possibilities of SCD and prevent late onset of SVT. […] In addition, there is an associated rise in incidence of atrial fibrillation in patients with WPW which may be reduced with prophylactic RF ablation of the accessory pathway.
#53 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy
https://emedicine.medscape.com/article/159222-treatment
WPW syndrome is largely congenital or hereditary. […] No particular method exists to eliminate the possibility of developing APs. […] In the future, genetic recognition and counseling may become a useful tool. […] Asymptomatic patients who have a low-risk pathway and no SVT can be monitored expectantly, or they may undergo RF ablation to prevent any possibilities of SCD and prevent late onset of SVT. […] In addition, there is an associated rise in incidence of atrial fibrillation in patients with WPW which may be reduced with prophylactic RF ablation of the accessory pathway.