Smartphone ECG Based Successful Diagnosis of WPW Syndrome Under Both Resting and Stress Test Conditions: A Case Report

Abstract

Background: Wolff-Parkinson-White (WPW) syndrome arises from the presence of an accessory pathway in the heart, disrupting normal electrical conduction between the atria and ventricles. Diagnosis via electrocardiography typically reveals characteristic features such as Delta waves, shortened PR intervals, and RR variabilities. Case Summary: The authors present the case of a 23-year-old male with a history of tobacco and alcohol use, exhibiting electrocardiographic manifestations consistent with WPW syndrome. Employing a Smartphone-based 12-lead ECG and bicycle ergometer, additional testing under resting and stressed conditions revealed a spectrum of abnormalities including T-wave inversions, tachyarrhythmias, conduction blocks, ST depressions, shortened PR intervals, and persistent Delta waves. Despite the absence of symptoms, a stress test achieving 10 METS over 5 minutes demonstrated the potential for ventricular tachycardia. Discussion: Following evaluation by a cardiologist, a watchful waiting approach was recommended, with no pharmacological intervention prescribed. This report underscores the utility of smartphone ECG technology in managing WPW syndrome, offering insights into dynamic cardiac responses during stress and informing clinical decision-making. Regular follow-up ECG assessments at six-month intervals were advised to monitor for emerging symptoms. The importance of prompt consultation with a cardiologist upon symptom onset cannot be overstated, given the inherent risk of life-threatening arrhythmias associated with WPW syndrome.