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January 24, 1977, Vol 237, No. 4 >
ARTICLE | January 24, 1977

Tachyarrhythmias in Wolff-Parkinson-White Syndrome: Title and subTitle BreakAntiarrhythmic Drug Therapy FREE

Edward K. Chung, MD
[+] Author Affiliations

Reprint requests to Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107 (Dr Chung).


JAMA. 1977;237(4):376-379. doi:10.1001/jama.1977.03270310060012
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References

EVERY physician should be fully familiar with the Wolff-Parkinson-White (WPW) syndrome because it is frequently associated with the various ectopic tachyarrhythmias. In addition, the electrocardiographic findings in the WPW syndrome may closely resemble many other abnormalities that are frequently misinterpreted in our daily practice. The WPW syndrome was first recognized as a clinical entity by Wolff et al,1 in 1930. The ECG findings, which were later considered to be characteristic of this syndrome, were described by Wilson2 in 1915, and by Wedd3 in 1921. The tachyarrhythmias may occur at any time and may begin at birth or during infancy, childhood, or adult life. Sixty percent to 70% of the cases with WPW syndrome have been encountered in healthy individuals without organic heart disease.4

Wolff-Parkinson-White syndrome can be diagnosed by the surface 12-lead electrocardiogram, the His bundle electrogram, or vectorcardiogram. The typical ECG findings include a short

REFERENCES

1 +
Wolff L, Parkinson J, White PD:  Bundle branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia . Am Heart J 5:685-704, 1930;.
2 +
Wilson FN:  A case in which the vagus influenced the form of two ventricular complexes of the electrocardiogram . Arch Intern Med 16:1008-1027, 1915;.
3 +
Wedd AM:  Paroxysmal tachycardia, with reference to normotropic tachycardia and the role of the extrinsic cardiac nerves . Arch Intern Med 27:571-590, 1921;.
4 +
Chung EK, Walsh TJ, Massie E:  Wolff-Parkinson-White syndrome . Am Heart J 69:116-133, 1965;.
5 +
Chung, EK: Electrocardiography: Practical Applications with Vectorial Principles . Hagerstown, Md, Harper & Row Publishers, 1974;, pp 341-361.
6 +
Lown B, Ganong WF, Levine SA:  The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action . Circulation 5:693-706, 1952;.
7 +
Chung EK: Vectorcardiography: Self Assessment . Hagerstown, Md, Harper & Row Publishers, 1974;.
8 +
Massumi RA, Vera Z, Mason DT:  The Wolff-Parkinson-White syndrome . Mod Concepts Cardiovasc Dis 42:41-46, 1973;.
9 +
Gallagher JJ, Gilbert M, Svenson RH, et al:  Wolff-Parkinson-White syndrome: The problem, evaluation and surgical treatment . Circulation 51:767-785, 1975;.
10 +
Krikler DM, Wellens HJJ:  The Wolff-Parkinson-White and related syndromes , in Krikler DM, Goodwin JF (eds): Cardiac Arrhythmias , Philadelphia, WB Saunders Co, 1975;, pp 144-181.
11 +
Tonkin AM, Gallagher JJ, Wallace AG.  Tachyarrhythmias in Wolff-Parkinson-White syndrome: Treatment and prevention . JAMA 235:947-949, 1976;.
12 +
Dreifus LS, Haiat R, Watanabe Y, et al:  Ventricular fibrillation: A possible mechanism of sudden death in patients with Wolff-Parkinson-White syndrome . Circulation 43:520-527, 1971;.
13 +
Kaplan MA, Cohen KL:  Ventricular fibrillation in the Wolff-Parkinson-White syndrome . Am J Cardiol 24:259-264, 1969;.
14 +
Coumel P, Attuel P:  Localization of the circus movement during reciprocating tachycardia in Wolff-Parkinson-White syndrome , in Narula OS (ed): His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 343-366.
15 +
Narula OS:  Electrophysiologic evaluation of accessory conduction pathways , Narula OS (ed): in His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 313-342.
16 +
Wellens HJJ, Durrer D:  The role of accessory atrioventricular pathway in reciprocal tachycardia: Observations in patients with and without Wolff-Parkinson-White syndrome . Circulation 52:58-72, 1975;.
17 +
Durrer D, Schuilenburg RM, Wellens HJJ:  Preexcitation revisited . Am J Cardiol 25:690-697, 1970;.
18 +
Rosen KM, Lopez Arostequi F, Pouget JM:  Preexcitation with normal P-R interval . Chest 62:581-586, 1972;.
19 +
Rosen KM, Barwolf C, Ehsani A, et al:  Effects of lidocaine and propranolol on the normal and anomalous pathways in patients with preexcitation . Am J Cardiol 30:801-809, 1972;.
20 +
Wellens HJ:  Effects of drugs on Wolff-Parkinson-White syndrome . Narula OS (ed): in His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 367-385.
21 +
Josephson ME, Kastor JA, Kitchen JG III:  Lidocaine in Wolff-Parkinson-White syndrome with atrial fibrillation . Ann Intern Med 84:44-45, 1976;.
22 +
Mandel WJ, Laks MM, Obayashi K, et al:  The Wolff-Parkinson-White syndrome: Pharmacologic effects of procaine amide . Am Heart J 90:744-754, 1975;.
23 +
Wellens HJJ, Durrer D:  Effects of procaine amide, quinidine, and ajmaline in the Wolff-Parkinson-White syndrome . Circulation 50:114-120, 1974;.
24 +
Gallagher JJ, Svenson RH, Sealy WC, et al:  The Wolff-Parkinson-White syndrome and the preexcitation dysrhythmias: Medical and surgical management . Med Clin North Am 60:101-123, 1976;.

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1 +
Wolff L, Parkinson J, White PD:  Bundle branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia . Am Heart J 5:685-704, 1930;.
2 +
Wilson FN:  A case in which the vagus influenced the form of two ventricular complexes of the electrocardiogram . Arch Intern Med 16:1008-1027, 1915;.
3 +
Wedd AM:  Paroxysmal tachycardia, with reference to normotropic tachycardia and the role of the extrinsic cardiac nerves . Arch Intern Med 27:571-590, 1921;.
4 +
Chung EK, Walsh TJ, Massie E:  Wolff-Parkinson-White syndrome . Am Heart J 69:116-133, 1965;.
5 +
Chung, EK: Electrocardiography: Practical Applications with Vectorial Principles . Hagerstown, Md, Harper & Row Publishers, 1974;, pp 341-361.
6 +
Lown B, Ganong WF, Levine SA:  The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action . Circulation 5:693-706, 1952;.
7 +
Chung EK: Vectorcardiography: Self Assessment . Hagerstown, Md, Harper & Row Publishers, 1974;.
8 +
Massumi RA, Vera Z, Mason DT:  The Wolff-Parkinson-White syndrome . Mod Concepts Cardiovasc Dis 42:41-46, 1973;.
9 +
Gallagher JJ, Gilbert M, Svenson RH, et al:  Wolff-Parkinson-White syndrome: The problem, evaluation and surgical treatment . Circulation 51:767-785, 1975;.
10 +
Krikler DM, Wellens HJJ:  The Wolff-Parkinson-White and related syndromes , in Krikler DM, Goodwin JF (eds): Cardiac Arrhythmias , Philadelphia, WB Saunders Co, 1975;, pp 144-181.
11 +
Tonkin AM, Gallagher JJ, Wallace AG.  Tachyarrhythmias in Wolff-Parkinson-White syndrome: Treatment and prevention . JAMA 235:947-949, 1976;.
12 +
Dreifus LS, Haiat R, Watanabe Y, et al:  Ventricular fibrillation: A possible mechanism of sudden death in patients with Wolff-Parkinson-White syndrome . Circulation 43:520-527, 1971;.
13 +
Kaplan MA, Cohen KL:  Ventricular fibrillation in the Wolff-Parkinson-White syndrome . Am J Cardiol 24:259-264, 1969;.
14 +
Coumel P, Attuel P:  Localization of the circus movement during reciprocating tachycardia in Wolff-Parkinson-White syndrome , in Narula OS (ed): His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 343-366.
15 +
Narula OS:  Electrophysiologic evaluation of accessory conduction pathways , Narula OS (ed): in His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 313-342.
16 +
Wellens HJJ, Durrer D:  The role of accessory atrioventricular pathway in reciprocal tachycardia: Observations in patients with and without Wolff-Parkinson-White syndrome . Circulation 52:58-72, 1975;.
17 +
Durrer D, Schuilenburg RM, Wellens HJJ:  Preexcitation revisited . Am J Cardiol 25:690-697, 1970;.
18 +
Rosen KM, Lopez Arostequi F, Pouget JM:  Preexcitation with normal P-R interval . Chest 62:581-586, 1972;.
19 +
Rosen KM, Barwolf C, Ehsani A, et al:  Effects of lidocaine and propranolol on the normal and anomalous pathways in patients with preexcitation . Am J Cardiol 30:801-809, 1972;.
20 +
Wellens HJ:  Effects of drugs on Wolff-Parkinson-White syndrome . Narula OS (ed): in His Bundle Electrocardiography and Clinical Electrophysiology . Philadelphia, FA Davis Co, 1975;, pp 367-385.
21 +
Josephson ME, Kastor JA, Kitchen JG III:  Lidocaine in Wolff-Parkinson-White syndrome with atrial fibrillation . Ann Intern Med 84:44-45, 1976;.
22 +
Mandel WJ, Laks MM, Obayashi K, et al:  The Wolff-Parkinson-White syndrome: Pharmacologic effects of procaine amide . Am Heart J 90:744-754, 1975;.
23 +
Wellens HJJ, Durrer D:  Effects of procaine amide, quinidine, and ajmaline in the Wolff-Parkinson-White syndrome . Circulation 50:114-120, 1974;.
24 +
Gallagher JJ, Svenson RH, Sealy WC, et al:  The Wolff-Parkinson-White syndrome and the preexcitation dysrhythmias: Medical and surgical management . Med Clin North Am 60:101-123, 1976;.

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