There are two kinds of pre-excitation syndromes: the Wolf Parkinson White syndrome or ventricular pre-excitation true and Lown Ganong Levine or accele

WPW syndrome is a congenital disease. In addition, described a familial incidence and is sometimes associated with other abnormalities such as Ebstein's disease, usually the heart is otherwise normal.

It is a rare cardiac disease, which is included within the so-called pre-excitation syndromes and is characterized by the presence of cardiac arrhythmia (irregular heartbeat) and a characteristic electrocardiogram recording. In cardiology preexcitation is called the situation in which the ventricular mass is activated earlier than would be expected, in part or in full.

Appears in about 4 in 100,000 healthy individuals of any age and can still be considered but overall a rare disease, its incidence in Western countries is steadily increasing due to the practice of routine electrocardiograms. The statistics speak to that seen in the electrocardiogram of almost 2 people per 1000 in adults and is often present in 1 in 500 individuals attending a cardiology clinic, the second most frequent cause of paroxysmal supraventricular tachycardia.

Cardiography can be an incidental finding and study of asymptomatic throughout the patient's life.

There are two kinds of pre-excitation syndromes: the Wolf Parkinson White syndrome or ventricular pre-excitation true and Lown Ganong Levine or accelerated atrioventricular conduction.

Other names of the syndrome

WPW Syndrome

Wolff Parkinson White Family

Wolf Parkinson White type preexcitation, Syndrome

Ventricular preexcitation True, Syndrome

Accessory atrioventricular pathways, Syndrome

Preexcitation syndrome

Causes, incidence, and risk factors

The current that causes the heart to contract normally extends along the right atrium to the ventricle via a single bundle of fibers.

In people with Wolff-Parkinson-White, there is an additional atrioventricular path leads to this "reentrant supraventricular tachycardia", a rapid heart rate that starts above the ventricles.

Often you can find the extra electrical pathway syndrome Wolf-Parkinson-White very precisely. This syndrome is one of the most common causes of fast heart rate disorders (tachyarrhythmias) in infants and children.

The frequency of episodes of rapid heart rate depends on the patient. Some patients with Wolff-Parkinson-White may have only a few episodes of tachycardia, while others may experience tachycardia or twice a week. In some cases, patients can be completely asymptomatic, in which case the additional route is often found that when a physician requests an electrocardiogram for some other purpose.

Symptoms

However, in these patients there is a high incidence of tachyarrhythmias ranging from 12 to 80%, the most common is paroxysmal supraventricular tachycardia followed by atrial fibrillation.

A person with WPW syndrome may have:

Palpitations (sensation of feeling heartbeat)

Angina

Syncope

Anxiety

Fainting

Dizziness

Shortness of breath

Chest pain or tightness

Signs and tests

The diagnosis typically relies heavily on clinical finding characteristic electrocardiographic changes:

Short PR interval, less than 120 msec.

"Delta" wave by slurring of the ascending limb of QRS in D1, aVL, V5 and V6. QRS complexes can be wide, for interventricular conduction disturbance.

Altered ventricular repolarization.

Diagnostic tests to be undertaken are:

Electrocardiogram

Continuous ambulatory ECG monitoring: Holter

Intracardiac Electrophysiology Study

Some authors consider a variant of Wolff-Parkinson-White the presence of a short PR accompanied by supraventricular tachycardia.

Early diagnosis of Wolf Parkinson White syndrome is of particular interest, because although it is usually a benign syndrome usually with a good prognosis, especially if presented in isolation, sometimes has a high degree of morbidity (sum of disease affecting an individual or a group during a given time) with atrial fibrillation with ventricular response extremely fast, which can even lead to ventricular fibrillation and sudden death.

In infants, the Wolf Parkinson White syndrome usually disappears during the first year of life in 63% of cases.

The patient with WPW syndrome with symptoms (tachycardia) needs to be studied in a cardiology department.

Treatment

Treatment depends on symptoms. If the diagnosis has been a chance finding on the ECG, without symptoms, not accurate in patients with symptoms:

The goal of treatment is to reduce symptoms with decreased episodes of tachycardia (rapid heart rate).

Medications may be used as adenosine, antiarrhythmics and amiodarone to control or prevent episodes of tachycardia. Digoxin, verapamil and beta blockers are not indicated in this type of tachycardia.

Other treatments to stop the persistent tachycardia are electrical cardioversion (shock) or ablation catheter with a special type of energy called radiofrequency. This destroys the extra route.

The surgery can provide permanent cure for this disease involves the ablation of the accessory pathway through an open heart surgery. Surgery is a good way to cure this disease, but usually only used when the patient needs surgery for a coincidental pathology.

Complications

Reduction in blood pressure caused by rapid heart rate sustained. The most severe form of arrhythmia is atrial fibrillation, which quickly leads to shock and, therefore, requires emergency treatment (cardioversion).

Heart failure

Side effects of medications used to treat this syndrome (see the specific medication)

Complications of surgery

Call your health care

Seek medical attention if symptoms occur that indicate the possible presence of Wolff-Parkinson-White or if you already have the disease and symptoms worsen or do not improve with treatment.

Recommendations

Activity

Avoid activities that may desencadenarle an attack, such as strenuous sports.

Avoid activities that transient loss of consciousness (syncope) can be dangerous.

Diet

Avoid stimulants like caffeinated drinks and tea.