Wolff-Parkinson-White

Pre-excitation

Recognition

  • Short PR <120 ms
  • Delta wave (slurred QRS upstroke)
  • QRS >110 ms
  • T wave changes

Key findings

  • Type A: positive delta V1 (left-sided pathway)
  • Type B: negative delta V1 (right-sided)

Clinical importance

  • AVRT (narrow / wide QRS)
  • Pre-excited AF — risk of VF; avoid AV-nodal blockers

Management pearls

  • AVRT: vagal manoeuvres, adenosine
  • Pre-excited AF: procainamide / DC cardioversion
  • Definitive: catheter ablation
WardRound

WardRound

Clinical Decisions in Seconds