Wolff-Parkinson-White Syndrome

Abstract

Evaluation of the patient with Wolff-Parkinson-White (WPW) syndrome with tachyarrhythmia is often difficult, since episodes of tachyarrhythmia most often subside spontaneously before medical observation is obtained. Twenty patients with WPW syndrome documented by standard electrocardiogram, who had histories suggesting tachyarrhythmia, were selected for study with the Holter ten-hour ECG monitoring system. This system allowed flexibility of activity during the monitoring period. Episodes of tachyarrhythmia were documented by these techniques in five of the 20 patients studied. Paroxysmal atrial tachycardia was documented in all five, and one patient had both atrial tachycardia and an unrecognized episode of atrial fibrillation. Two patients have been monitored while receiving propranolol hydrochloride therapy, confirming the clinical impression of improvement. Long-term monitoring has been found to be a valuable technique for the evaluation of the patient with WPW syndrome and possible tachyarrhythmias.