Home / ECG Quiz Case # 5 : Answers

ECG Quiz Case # 5 : Answers

1. This patient has Wolff-Parkinson-White Syndrome (WPW). The etiology of her arrhythmia can be mapped to the slowed, slurred upstroke on the R-wave. This slow depolarization, also known as preexcitation, is manifested on ECG as a delta wave, and is pathognomonic of a bypass-tract mediated reentry tachycardia.

 

073114

 

2. Acute Management options

unstable -> synchronized DC cardioversion

stable -> anti-arrhythmics (prolongation of accessory pathway: sotalol, amiodarone, flecanide, procanamide)
drugs that shorten refractory period are contraindicated (digoxin)
avoid drugs that increase ventricular rate (verapamil and lidocaine)
avoid drugs that have no effect on refractory period of accessory pathway (beta-blockers)

Long-term Management -> radio-frequency ablation

 

 

Want To Read More……?

 

Medscape : Wolff-Parkinson-White Syndrome

 

Life in the Fast Lane : Wolff-parkinson-white-syndrome

 

 

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