TITLE:
Choice of Management in a Rare Case of Symptomatic Wolff-Parkinson-White (WPW) Syndrome Type B
AUTHORS:
Choe Yee Xian, Rafiq Shajahan, Puay Sheng Hwa, Naganathan Pillai, Ganesh Kasinathan
KEYWORDS:
Wolff-Parkinson-White Type B, Accessory Pathway, Amiodarone, Palpitation, Radiofrequency Ablation
JOURNAL NAME:
Open Access Library Journal,
Vol.2 No.12,
December
14,
2015
ABSTRACT:
Introduction: Wolff-Parkinson-White (WPW) syndrome type B is a congenital
condition involving abnormal electrical conduction between the atria and the
ventricles that provide an accessory pathway (AP) for a re-entrant tachycardia
circuit. Background: This case report illustrates a 28-year-old male who presented
with multiple episodes of rapid, regular palpitations associated with dizziness
and nausea. These episodes of palpitations often resolve spontaneously.
Physical examination revealed normal first and second heart sounds with no
audible murmurs. Other systemic examinations were unremarkable. A 12 lead
electrocardiogram showed an atrioventricular re-entrant tachycardia (AVRT) of
210 beats per minute. Intravenous amiodarone was given to which he responded.
Post pharmacological cardioversion, the repeated ECG showed shortened PR
interval and broad QRS complexes associated with negative delta waves in lead
V1, T-wave inversion in inferior leads and precordial leads of V5-V6 which
represented a Type B pattern. He was then referred to the electrophysiology
unit at the National Heart Institute for radiofrequency ablation (RFA) and
Holter monitoring. Conclusion: Wolff-Parkinson-White (WPW) Type B should be
considered as a differential diagnosis for a young individual who presents with
frequent palpitations. RFA is well known as a permanent solution to the
prevention of tachyarrhythmia.