Electrocardiographic and epicardial mapping studies are reported in a child with an atrial septal defect and a variant of type A Wolff-Parkinson-White (WPW) syndrome. The vectorcardiogram suggested a posterior area of early activation and this was confirmed by epicardial mapping studies. Premature activation apparently occurred from a site near the endocardium of the basal region of the left ve...

In Wolff-Parkinson-White Syndrome (WPW), presence of accessory pathways causes various tachyarrhythmias that lead to different symptoms and clinical conditions in patients. Atrial fibrillation is observed in about 20-30% of this group of patients. Life threatening malignant ventricular arrhythmias and sudden cardiac deaths are observed in patients having rapid conduction in accessory pathways a...

Adenosine by rapid intravenous bolus is frequently utilized in clinical practice as both a pharmacologic treatment for supraventricular (reentrant) tachycardia and in provocative testing for the diagnosis of Wolff-Parkinson-White (WPW) syndrome. This is a case report of an otherwise healthy adolescent female who received adenosine during a provocative test for WPW syndrome. Immediately after re...

Sudden cardiac death (SCD) in young athletes is always dramatic, because unexpected, and is sometimes a challenge to investigate. The prevalence is estimated at 0.6 per 100,000 in the United States. Coronary anomalies are the second most common cause of SCD in young athletes (16%) but are, unfortunately, difficult to recognize before a serious clinical event. Wolff-Parkinson-White (WPW) syndrom...

The patient with the Wolff-Parkinson-White (WPW) ECG pattern has much in common with patients with other entities, such as long-QT syndrome and Brugada syndrome, which are associated with an identifying abnormality on ECG. All are relatively benign in the majority of afflicted individuals but nonetheless carry a risk of unexpected sudden death, which begs for some attempt at risk management. Th...

Current guidelines (1) and expert opinion (2) do not recommend routine electrophysiologic (EP) study in patients with asymptomatic Wolff-Parkinson-White (WPW) syndrome. Patients who engage in “high-risk” occupations or those patients in whom a pre-excitation pattern precludes them from following their chosen career may be exceptions. In this issue of the Journal, Pappone et al. (3) report the r...

For patients with Wolff-Parkinson-White (WPW) syndrome, several algorithms have been published for the prediction of the location of accessory pathways (APs) from the QRS morphology on the ECG. Hence, these algorithms may fail to identify the locations of midseptal or right APs (1, 2). APs may traverse the central fibrous trigone or involve the right atrial appendage; these may be mistaken as a...

Wolff-Parkinson-White syndrome (WPW) is the most common indication for invasive cardiac catheterization and electrophysiological testing in children. There are presently 2 predominant reasons for this. First, patients with WPW are, as the original 1930 investigators so eloquently pointed out, at risk for “paroxysmal tachycardia.”1 Supraventricular tachycardia is typically either orthodromic or,...

OBJECTIVE Wolff-Parkinson-White (WPW) syndrome presents with paroxysmal supraventricular tachycardia and is characterized by electrocardiographic (ECG) findings of a short PR interval and a delta wave. The objective of this study was to evaluate the electrophysiological properties of children with WPW syndrome and to develop an algorithm for the management of these patients with limited access ...