The Wolff-Parkinson-White syndrome is an electrocardiographic syndrome which is the expression of an anomalous atrioventricular conduction pathway, congenital in origin. This pathway forms a bypass which enables the supraventricular impulse to bypass the AV node, bundle of His and distal conducting system, and so activate or pre-excite the ventricles.
The anomalous bypass is also known as the Bundle of Kent, is a thin filamentous structure which may be situated ectopically anywhere along the atrioventricular ring – the fibrous junction separating the atria from the ventricles.
Basic ECG presentation of WPW Syndrome
- A short PR interval
- A slurred, thickened, initial upstroke of the QRS complex, which is termed the delta wave.
- A relatively normal – narrow – ensuing terminal QRS deflection. This is sometimes referred to as the main QRS deflection.
- Slight widening of the QRS complex as a whole.
- Secondary ST segment and T wave changes that is changes which are secondary to the abnormal intraventricular conduction.
Other pathologies mimicked by WPW syndrome
- Right Ventricular Hypertrophy
- Posterior Wall MI
- Anterolateral or Inferior Wall MI
- Bundle Branch Block
- Primary Myocardial Disease
- Ventricular Tachycardia