Syndrome Effect Ecg

1. WPW SYNDROME
Wolff-Parkinson-White
BY:-
Aditya Prabhune & Shravni Nikhil Pawar
Here is where the presentation begins

2. INTRODUCTION
01
CAUSES
02
PATHOPHYSIOLOGY
03
CONDUCTION
04
ECG
05
SYMPTOMS
&
TREATMENT
06
Table of contents

3. Introduction
WHAT IS WPW SYNDROME?
Wolff–Parkinson–White syndrome (WPWS) is a disorder due to
a specific type of problem with the electrical system of
the heart involving an accessory pathway able to conduct electrical
current between the atria and the ventricles, thus bypassing
the atrioventricular node. About 60% of people with the electrical
problem developed symptoms, which may include an abnormally
fast heartbeat, palpitations, shortness of breath, lightheadedness,
or syncope. Rarely, cardiac arrest may occur. The most common
type of irregular heartbeat that occurs is known as paroxysmal
supraventricular tachycardia.

5. CAUSES
 The cause of WPW is typically unknown and is likely due to a combination
of chance and genetic factors. A small number of cases are due to
a mutation of the PRKAG2 gene which may be inherited in an autosomal
dominant fashion.
 The mechanism involves an accessory electrical conduction
pathway between the atria and the ventricles. It is associated with other
conditions such as Ebstein anomaly and hypokalemic periodic paralysis.
 The diagnosis of WPW occurs with a combination of palpitations and when
an electrocardiogram (ECG) show a short PR interval and a delta wave. It
is a type of pre-excitation syndrome.

6. PATHOPHYSIOLOGY
 Electrical activity in the normal human heart begins when a cardiac action potential arises in
the sinoatrial (SA) node, which is located in the right atrium. From there, the electrical
stimulus is transmitted via internodal pathways to the atrioventricular (AV) node.
 After a brief delay at the AV node, the stimulus travels through the bundle of His to the left
and right bundle branches and then to the Purkinje fibers and the endocardium at the apex
of the heart, then finally to the ventricular myocardium.
 Individuals with WPW have an accessory pathway that communicates between the atria
and the ventricles, in addition to the AV node. This accessory pathway is known as the
bundle of Kent.
 It does not share the rate-slowing properties of the AV node and may conduct electrical
activity at a significantly higher rate than the AV node.
 For instance, in the example above, if an individual had an atrial rate of 300 beats per
minute, the accessory bundle may conduct all the electrical impulses from the atria to the
ventricles, causing the ventricles to contract at 300 beats per minute.
 Extremely rapid heart rates such as this may result in hemodynamic instability
or cardiogenic shock. In some cases, the combination of an accessory pathway
and abnormal heart rhythms can trigger ventricular fibrillation, a leading cause of sudden
cardiac death.

7. NORMAL & WPW SYNDROME CONDUCTION

8. PATHWAY ASSOCIATED
WITH AVRT

9. ECG
WPW is commonly diagnosed on the basis of the electrocardiogram in an asymptomatic individual. In this
case, it is manifested as a delta wave, which is a slurred upstroke in the QRS complex that is associated
with a short PR interval. The short PR interval and slurring of the QRS complex are reflective of the
impulse making it to the ventricles early (via the accessory pathway) without the usual delay experienced
in the AV node.

10. ECG
In WPW, the ECG may show a short PR interval, a widened QRS complex, and a
slurring of the QRS complex, known as a delta wave. This is due to an accessory
pathway that allows for early activation of the ventricles, leading to the characteristic
ECG changes.In atrial fibrillation, the ECG may show an irregularly irregular rhythm
with no discernible P waves and a rapid ventricular response. The absence of
organized atrial activity and irregular ventricular response is characteristic of atrial
fibrillation.