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Individuals with Wolff-Parkinson White syndrome may range from the undiagnosed, asymptomatic patient to the patient experiencing sudden arrhythmic death.This article hopes to provide the ad- vanced emergency nurse practitioner with a background on the discovery of this potentially lethal arrhythmia, its incidence and characteristic electrocardiogram findings, as well as an overview on emergency management and long term management options of this syndrome. Key words: arrhythmia, tachyarrhythmia, Wolff-Parkinson-White N INDIVIDUAL with Wolff–Parkinson– Marriott recorded that Wilson presumed that White (WPW) syndrome may exist in a abnormalities seen on the electrocardiogram Acontinuum of the disorder that ranges (ECG) were caused by some form of ventric- from the undiagnosed, asymptomatic patient ular bundle branch block. Just before 1930, to the patient experiencing sudden arrhyth- and nearly simultaneously, Wolff and White in mic death through an evolution of the dis- Boston, and Parkinson in London had amassed order or induced by inappropriate treatment and described several cases of patients with of the tachyarrhythmia (Keating, Morris, & ECGs demonstrating “bizarre ventricular com- Brady, 2003). WPW is a syndrome of ventricu- plexes and short P–R intervals” (Marriott, lar preexcitation in which the normal conduc- 1988, pp. 285–286). Marriott further reported tion of the atrial depolarization
Advanced Emergency Nursing Journal – Wolters Kluwer Health
Published: Jan 1, 2008
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