Arrhythmias in the Wolff-Parkinson-White syndrome
Identifieur interne : 002D43 ( Main/Exploration ); précédent : 002D42; suivant : 002D44Arrhythmias in the Wolff-Parkinson-White syndrome
Auteurs : Bertram J. Newman ; Ephraim Donoso ; Charles K. FriedbergSource :
- Progress in Cardiovascular Diseases [ 0033-0620 ] ; 1966.
Abstract
The incidence of the WPW anomaly in adults ranges from 0.1 to 3.1 per thousand and in children from 0.77 to 4.8 per thousand. Acquired heart disease as well as many congenital cardiac defects are associated with the WPW anomaly. Sixty to 70 per cent of patients demonstrating this pattern are males.Arrhythmias occur in about 40 to 80 per cent of patients, and tend to reoccur. The most common arrhythmia is atrial tachycardia. Atrial fibrillation and flutter are also seen. There is a high incidence of rapid ventricular rate with aberration in conduction in response to these arrhythmias (30 per cent). This rapid aberrant ventricular response may be confused with ventricular tachycardia and the criteria for diagnosis are described.Quinidine has been used to terminate the arrhythmias associated with the WPW syndrome. Although the use of digitalis in these arrhythmias has not achieved widespread acceptance, it should be employed as it is in situations not complicated by the WPW anomaly. Combination therapy with digitalis and quinidine has been successful in refractory cases. Electrical cardioversion has also been employed. There should be no deley in instituting therapy since several instances of death have been reported during the acute attacks. Prophylactic use of quinidine is indicated when attacks tend to recur and are severe.The prognosis of the individual patient is affected by the presence or absence of underlying heart disease, age at onset of tachycardia, tendency for recurrence and duration and severity of the single episodes.
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DOI: 10.1016/S0033-0620(66)80003-8
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