Wolff-Parkinson-White syndrom

EF, ejection fraction CHF, chronic heart failure WPW, Wolff-Parkinson-White syndrome DC, direct current. 

Amiodarone (11), a benzofuran derivative, was initially developed as a coronary vasodilator in the early 1960 s [11,12]. Several years later, the efficacy of the compound as an antiarrhythmic agent began to be exploited. The first clinical trials with amiodarone were reported in 1974 [13]. Amiodarone was effective in controlling the tachyarrhythmias of eleven patients with Wolff-Parkinson-White syndrome. Since that time the compound has been studied extensively [14,15]. Recently, in the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial (CAMIAT), amiodarone was shown to reduce mortality during a mean 18 month period following myocardial infarction (13.8% deaths in placebo group vs. 2.1 % deaths in the treatment group) [16]. 

Accessory pathways occur in Wolff-Parkinson-White syndrome (preexcitation phenomena) and Does not belong to any of the 3 subclasses (A, B or C), but does have some properties of each Retrograde AV node RP antegrade RP not affected. 

Conduction abnormalities Use caution in patients with sick sinus syndrome, Wolff-Parkinson-White syndrome or bundle branch block. 

Hypersensitivity to amide local anesthetics Stokes-Adams syndrome Wolff-Parkinson-White syndrome severe degrees of sinoatrial, atrioventricular (AV), or intraventricular block in the absence of an artificial pacemaker. 

Atrial fibrillation or atrial flutter associated with an accessory bypass tract such as in Wolff-Parkinson-White syndrome or short PR syndrome. 

Wolff-Parkinson-White syndrome In several cases, the tachycardia was replaced by a severe bradycardia requiring a demand pacemaker after propranolol administration with as little as 5 mg. 

Zolmitriptan- Patients with symptomatic Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders should not receive zolmitriptan. 

WNL within normal limits WPW Wolff-Parkinson-White syndrome... 

Diagnostically in Wolff-Parkinson-White syndrome to restore the PRS complex to normal duration... 

Cardiomyopathy Conduction blocks Wolff-Parkinson-White syndrome Inner ear... 

Digitalis should be avoided in the therapy of arrhythmias associated with Wolff-Parkinson-White syndrome because it increases the probability of conduction of arrhythmic atrial impulses through the alternative rapidly conducting atrioventricular pathway. It is explicitly contraindicated in patients with Wolff-Parkinson-White syndrome and atrial fibrillation (see Chapter 14 Agents Used in Cardiac Arrhythmias). 

It was recognized at the start of the 20th century that reentry in simple in vitro models (eg, rings of conducting tissues) was permanently interrupted by transecting the reentry circuit. This concept has now been applied to treat clinical arrhythmias that occur as a result of reentry in anatomically delineated pathways. For example, interruption of accessory atrio-ventricular connections can permanently cure arrhythmias in patients with the Wolff-Parkinson-White syndrome. Such... 

Daniel, T., and Carling, D. 2002. Functional analysis of mutations in the gamma 2 subunit of AMP-activated protein kinase associated with cardiac hypertrophy and Wolff-Parkinson-White syndrome. J Biol Chem 277 51017-51024. 

Sidhu, J. S., Rajawat, Y. S., Rami, T. G., Gollob, M. H., Wang, Z., Yuan, R., Marian, A. J., DeMayo, F. J., Weilbacher, D., Taffet, G. E., Davies, J. K., Carling, D., Khoury, D. S., and Roberts, R. 2005. Transgenic mouse model of ventricular preexcitation and atrioventricular reentrant tachycardia induced by an AMP-activated protein kinase loss-of-function mutation responsible for Wolff-Parkinson-White syndrome. Circulation 111 21-29. 

Some patients may experience hearing loss, which may accompany diabetes. Usually, type 2 diabetes is described in individuals with MELAS, although type 1 or insulin-dependent diabetes also may be observed. Palpitations and shortness of breath may be present in some patients with MELAS secondary to cardiac conduction abnormalities such as Wolff-Parkinson-White syndrome. Acute onset of gastrointestinal manifestations (e.g., acute onset of abdominal pain) may reflect pancreatitis, ischemic colitis, and intestinal obstruction. Numbness, tingling sensation, and pain in the extremities can be manifestations of peripheral neuropathy. Some patients may have the presentation of Leigh syndrome (i.e., subacute necrotizing encephalopathy). 

Amiodarone, for example (Fig. 1.12), was introduced as a coronary dilator for angina, but concern about comeal deposits, discoloration of skin exposed to sunlight and thyroid disorders led to the withdrawal of the drug in 1967. However, in 1974 amiodarone was found to be highly effective in the treatment of a rare type of arrhythmia known as the Wolff-Parkinson-White syndrome. Accordingly, amiodarone was reintroduced specifically for that purpose [22]. 

A 61-year-old woman with Wolff-Parkinson-White syndrome, who had previously had QTC interval prolongation with both sulpiride 1200 mg/day and... 

Su K-P, Lane H-Y, Chuang C-L, Chen K-P, Shen WW. Olanzapine-induced QTc prolongation in a patient with Wolff-Parkinson-White syndrome. Schizophr Res 2004 66 191-2. 

A case of cocaine-induced myocardial ischemia in pregnancy mistaken for Wolff-Parkinson-White syndrome has been reported (49). 

Pregnancy increases the incidence of dysrhythmias in patients with Wolff-Parkinson-White syndrome. This association may relate to an effect of estrogen, increased plasma volume, or increased maternal stress or anxiety. 

Kuczkowski KM. Chest pain and dysrhythmias in a healthy parturient Wolff-Parkinson-White syndrome vs cocaine-induced myocardial ischemia Anaesth Intern Care 2004 32 143-4. 

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