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Cardiology

Question
35 out of 57
 

All are true about WPW syndrome except? (AIIMS Nov 2011)



A More common in female

B Delta wave in ECG

C His bundle study is done to diagnose

D Can occur in a normal heart.

Ans. A

More common in female

WPW syndrome (Wolff-Parkinson-White) (LQ 2012)

1. WPW syndrome is more common in males.

2. It can occur in a normal heart. It is seen in MVP, cardiomyopathy, Ebstein anomaly.

3. It is caused by bundle of Kent which is a congenital abnormal extra or accessory conduction pathway between the atria and ventricles.

4. This pathway may communicate between the left atrium and the left ventricle, in which case it is termed a "type A pre-excitation", or between the right atrium and the right ventricle, in which case it is termed a "type B pre-excitation".

5. Problems arise when this pathway creates an electrical circuit that bypasses the AV node. The AV node is capable of slowing the rate of conduction of electrical impulses to the ventricles, whereas the bundle of Kent lacks this capability.

6. When an aberrant electrical connection is made via the bundle of Kent, tachydysrhythmias results.

7. Resting ECG shows short P-R interval Qand wide QRS complex Q due to slurred upstroke or delta wave Q

8. Patients present with Supra Ventricular Tachycardia.

Extra Edge:

Diagnoses of WPW syndrome: His bundle study (Electrophysiology)

Treatment of WPW syndrome

1. Vagal stimulation

2. Injection adenosine

3. Calcium channel blocker

4. Procainamide

5. Beta blocker

6. IA or IC antiarrhythmic drug such as quinidine, flecainide, or propafenone are used in AF with fast ventricular rate because these drugs slow conduction & increase refractoriness in the WPW syndrome.

(Ref. Hari. 18th ed., Pg -1891)(LQ 2012)

Ablation of the abnormal pathway is the most Definite therapy.

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