Wolff-Parkinson-White syndrome - a disease which manifests itself in the structure of congenital heart disorders.This cardiac abnormality characterized antesistoliey one ventricle, and then is formed atrioventricular reciprocating tachycardia, which manifests flutter and atrial fibrillation, as a result of excitation of additional vascular bundles.They participate in conjunction with ventricular fibrillation.
Wolff-Parkinson-White 25% has all the signs of paroxysmal atrial tachycardia.Since 1980, a heart disease divide syndrome (WPW) and the phenomenon (WPW).For a phenomenon characteristic electrocardiogram with evidence of anterograde behavior, where the atrioventricular reciprocating tachycardia is absolutely evident.
Wolff-Parkinson-White syndrome - a congenital heart abnormality, in which predvozbuzhdёnnoe state is accompanied by ventricular tachycardia symptomatic.
Wolff-Parkinson-White syndrome causes
As a rule, the disease has no connecting lines between th
Many patients Wolff-Parkinson-White syndrome is formed by other heart defect with congenital etiology, for example, is Ehlers-Danlos syndrome and Marfan (connective tissue dysplasia) or mitral valve prolapse.Sometimes an anomaly of the disease occurs in conjunction with a defect in the ventricular septum and atria or in patients with congenital marked "tetralogy of Fallot."
In addition, there is evidence that the Wolff-Parkinson-White syndrome is a consequence of family heart pathologies.There is also the main cause of this disease include abnormal development of the heart of the system involved in conducting impulses to the presence of an additional bundle of Kent.In the formation of the syndrome Wolff-Parkinson-White syndrome, this beam performs one of the main functions.
Wolff-Parkinson-White syndrome symptoms
The disease occurs very rarely and 70% of patients have further any cardiac pathology.One of the main symptoms of the syndrome Wolff-Parkinson-White believes arrhythmias and tachyarrhythmias appear in the majority of patients with this disease.
clinical picture of the syndrome Wolff-Parkinson-White syndrome is mainly composed of the ECG changes in the form of certain ways, additionality between the atria and ventricles.In this case, a beam of Kent, is common in some other ways.He is the conductor of the pulse, making it a retrograde and anterogadno.In patients with such diseases, pulses are transmitted from the atria to the ventricles via the AV node or through additional ways of that bypass the node.Pulses, which are distributed on additional routes, much earlier time to depolarize the ventricles, in contrast to the impulses through the AV node.As a result, the ECG recorded characteristic changes to the underlying disease as a shortened interval PR, associated with the lack of delays before coming ventricular;deformation of the rising PR R-wave (delta wave) and wide QRS complexes resulting compound pulses, which come in two ways to the ventricles.Available additional ways of can sometimes be accompanied by such characteristic changes in the electrocardiogram.This is due to retrograde conduction of an impulse that occurs in 25% of cases.Such paths are hidden because all the signs of premature ventricular absolutely no ECG.Despite this, they relate to the circuit re-entry, which becomes a cause of tachyarrhythmia.
demonstration clinical syndrome of Wolff-Parkinson-White syndrome can occur at any age, but to a certain time, it may be asymptomatic.This disease is characterized cardiac arrhythmia as a reciprocating tachycardia on ventricular 80%, atrial fibrillation in 25%, and they flutter about 5% with a frequency of heart beat from 280 to 320 per minute.
Sometimes hallmarks syndrome Wolff-Parkinson-White syndrome are arrhythmia specific action - this tachycardia and ventricular premature beats, as the atria and ventricles.Such attacks arrhythmias arise mainly from emotional or physical stress, drinking alcohol or suddenly, for no apparent reason.
During the arrhythmic episodes in patients with Wolff-Parkinson-White syndrome appear palpitations, false angina, heart sinking, and the lack of air.When flutter and atrial fibrillation in patients appear fainting, dizziness with increased blood pressure, shortness of breath and impaired cerebral circulation.After switching pulses to the ventricles formed their fibrillation, which can cause sudden death.
syndrome Wolff-Parkinson-White syndrome paroxysmal fibrillation sometimes occur up to several hours and may be terminated, both independently and after the reflex actions.In protracted attacks requiring hospitalization of patients and their examination by the cardiologist.During the course of the syndrome Wolff-Parkinson-White syndrome is determined not only paroxysmal tachycardia, and mild noise systole, increased first tone and the splitting of the first and second pitch.
Almost all the symptoms of the disease in 13% of patients detected by accident.Thirty percent of the Wolff-Parkinson-White syndrome occurs with a number of heart disease.These include primary heart disease, subaortic stenosis, inversion ventricular endocardial fibroelastosis, coarctation of the aorta, the ventricular defect and tetralogy of Fallot.
Patients diagnosed with Wolff-Parkinson-White syndrome is sometimes noted mental retardation.Short interval P-Q, advanced QRS-complex, aimed to the left, forward or back D-wave formation interval P j detected in the ECG for this anomaly.
Wolff-Parkinson-White syndrome treatment
absence of paroxysmal arrhythmias in the syndrome of Wolff-Parkinson-White does not require special treatment.A significant hemodynamic attacks, accompanied by signs of heart failure, angina, hypotension and syncope, are in need of external electrical cardioversion acts or esophageal pacing.
Sometimes arrhythmias are used for the relief of Valsalva sinus massage and use reflex vagal maneuvers, and injected ATP or verapamil, blocking calcium channels and the prescribed antiarrhythmic drugs such as procainamide, Ajmaline, propafenone and Kordaron.In the future, these patients show a lifelong therapy with antiarrhythmic action.
To prevent attacks of tachycardia with Wolff-Parkinson-White syndrome patients prescribed amiodarone, disopyramide and sotalol.When supraventricular paroxysmal tachycardia, against the background of the underlying pathology, intravenously administered adenosine.Also urgently appointed elektrodefibrilyatsiya the development of atrial fibrillation.And then recommend degradation pathways.
indications for surgical intervention in the syndrome of Wolff-Parkinson-White syndrome may have frequent episodes of tachyarrhythmia and atrial fibrillation, as well as young age or planned pregnancy, in which it is impossible to use long-term drug therapy.
When the organism resistance to these drugs and atrial fibrillation education, appoint additional ways catheterization radiofrequency ablation transseptal or retrograde access.The effectiveness of this treatment fails to reach 95% of relapses in 5%.
Radiofrequency ablation intracardiac currently considered the most effective and radical method to treat Wolff-Parkinson-White syndrome.This method allows the surgery in the future to eliminate repetitive tachyarrhythmias, which are very dangerous to human life.Radiofrequency ablation can be performed without access to the heart.All this is carried catheter and minimally invasive intervention, which has several kinds, depending on the operating principles of the same catheter.It is administered as a flexible conductor, through a blood vessel in the abnormal heart cavity.Then served a special frequency pulse destroys precisely those areas in the heart that are responsible for the rhythm disturbance.
Generally, the flow of patients with asymptomatic Wolff-Parkinson-White syndrome have a more favorable prognosis.Individuals who have a family history with aggravating consequences in the form of sudden death or for professional reasons, need constant supervision, and then treatment.
With existing complaints or life-threatening arrhythmia, necessary to carry out diagnostic tests in its complex in order to select the optimal therapies.
Patients with Wolff-Parkinson-White syndrome and undergoing surgery should be observed at the heart surgeon and cardiologist arrhythmology.
Wolff-Parkinson-White requires prevention, which is characterized by carrying out antiarrhythmic medication to prevent further repeated recurrences of arrhythmia.Such prevention is mostly secondary.