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Initial Evaluation of Patients with the Wolff-Parkinson-White Syndrome

  • George J. Klein
  • Arjun D. Sharma
  • Simon Milstein

Abstract

The classic electrocardiographic Wolff-Parkinson-White (WPW) pattern has been estimated to occur in 1 to 3 per 1,000 individuals [1]. Strictly speaking, only patients with a manifest delta wave and rapid-heart-beating should be considered as having WPW syndrome [2] but it is now known that many patients with the underlying substrate for this syndrome — namely, the accessory atrioventricular pathway — have “concealed” accessory pathways and have normal PR intervals and QRS morphology as the pathways conduct only in the retrograde direction [3,4]. The spectrum of WPW patients includes those with a purely benign “cosmetic” delta wave, those with troublesome but not life-threatening paroxysmal tachycardia, and those with a potentially life-threatening arrhythmia (most often atrial fibrillation with a rapid ventricular response that could lead to ventricular fibrillation) [5]. The evaluation of the patient with WPW syndrome depends a great deal on the clinical presentation. The main challenge to the physician is to find the relatively infrequent WPW patient who is at risk for a potentially lethal arrhythmia and to distinguish this patient from those that can be reassured or treated in a more methodical fashion with empirical drug trials.

Keywords

Atrial Fibrillation Ventricular Fibrillation Refractory Period Accessory Pathway Delta Wave 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Martinus Nijhoff Publishing 1986

Authors and Affiliations

  • George J. Klein
  • Arjun D. Sharma
  • Simon Milstein

There are no affiliations available

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