A Case of Supraventricular Tachycardia Associated With Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White syndrome (WPWS) is the most common form of ventricular pre-excitation. It is characterized by the presence of an accessory pathway between the atrium and ventricles which allows an alternative route for ventricular depolarization. Although most WPWS remain asymptomatic, others are prone to tachyarrhythmias that can be life-threatening. WPWS can present with variable tachyarrhythmias that require specific treatment considerations. We report a case of WPWS that was diagnosed following successful termination of narrow complex tachycardia. This is followed by a review of literature covering the diagnostic and initial therapeutic issues. Adenosine, a commonly used atrioventricular (AV) nodal blocking agent, is considered as the first-line therapeutic agent, which terminates regular narrow complex tachycardia. Clinicians need to be aware of the potential for adenosine to induce lethal tachyarrhythmias via AV nodal blockade and preferential conduction down the accessory pathway in patients with pre-excitation syndrome. J Med Cases. 2018;9(2):54-57 doi: https://doi.org/10.14740/jmc2693w