Atrial Fibrillation in Wolff Parkinson White (WPW) Syndrome: Case Report and Review of the Literature

Abstract

The occurrence of atrial fibrillation (AF) transmitted to the ventricles by an accessory pathway is a rare, potentially serious arrhythmia. The risk of ventricular fibrillation is a fatal complication that can be increased by certain medications such as digitalis. AF can be the initial presentation of WPW syndrome, in which case it is often poorly tolerated. We report the case of a 42-year-old patient with no particular history, who consulted for palpitations that appeared at rest, a few hours previously; systolic blood pressure was 80 mm Hg without signs of shock. The ECG showed rapid AF with wide QRS. After reduction by external electric shock, the post-ictal ECG was in favor of WPW syndrome. The initial assessment was quickly carried out, and the patient was treated with a combination of two antiarrhythmic drugs. The occurrence of rhythm disturbances requires an etiological assessment on which the specific treatment will depend. In WPW syndrome, stratification of the individual risk of sudden death is essential in the therapeutic management of patients.