WPW syndrome

In 1930, three researchers described a distinctive case (often in an apparently healthy young man) Tachycardia ( Pest ) It began when a patient with this condition reported in an academic journal a case of paroxysmal tachycardia with bundle branch block on an electrocardiogram (a condition where the patient has seizures and shows bundle branch block on an electrocardiogram). Wolff and White from the United States and Parkinson from the United Kingdom published a paper entitled "Short PR bundle branch block with paroxysmal tachycardia in a healthy young person". From this paper, the condition became known as Wolff-Parkinson-White syndrome, or the acronym WPW syndrome.

The nature of WPW syndrome is Atrioventricular node ( Hat training ) In fact, there is an accessory pathway that connects the atria and ventricles from birth, and delta waves are seen when the signal travels from the atrium to the ventricle through the accessory pathway. Overt ( Research ) WPW syndrome, where delta waves are sometimes seen Intermittent ( Life ) WPW syndrome: A case in which there is accessory pathway conduction only from the ventricle to the atrium and no delta waves are observed. Potential ( Detective ) This is called WPW syndrome.

An example of a delta wave is Atrial fibrillation ( Patience test ) When this occurs, unlike atrioventricular nodal conduction, atrial excitation is frequently transmitted to the ventricles via the accessory pathway, resulting in frequent ventricular excitation. The QRS width becomes wider and the number of ventricular excitations increases, making it mistaken for ventricular tachycardia, but it can be distinguished from this by the irregular RR interval. For this reason, when atrial fibrillation occurs in WPW syndrome, Fakeness ( Production ) This is called ventricular tachycardia.

When the ventricular activation frequency of pseudoventricular tachycardia increases, Ventricular fibrillation ( Graduate school ) Pseudoventricular tachycardia should be terminated early because it may progress to ventricular tachycardia.

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

　1930年に3名の研究者が特徴的な症例（外見は健康な青年がしばしば頻拍(ひんぱく)発作を起こし、心電図上で脚ブロックを示す）を学会誌に報告したのが始まりです。米国のウォルフ、ホワイト、英国のパーキンソンが共著で「健常な若い人にみられる発作性頻拍を伴うPR短縮の脚ブロック」という論文を発表しました。この論文から、ウォルフ・パーキンソン・ホワイト症候群、現在では頭文字をとったWPW症候群として知られるようになりました。

　WPW症候群の本質は、房室結節(ぼうしつけっせつ)以外に心房と心室を結ぶ副伝導路が生まれた時からあることで、心房から心室へ副伝導路を伝わる場合にデルタ波がみられます。常にデルタ波が存在する例を顕性(けんせい)WPW症候群、デルタ波が時々認められる例を間欠性(かんけつせい)WPW症候群、心室から心房へだけ副伝導路伝導がありデルタ波を示さない例を潜在性(せんざいせい)WPW症候群といいます。

　デルタ波のある例に心房細動(しんぼうさいどう)が生じると、房室結節伝導とは異なり、心房興奮が副伝導路を介して頻回に心室へ伝えられるために心室興奮も頻回になります。QRS幅は広くなり心室室興奮数が多くなるために心室頻拍と見間違いますが、RR間隔が不規則なことから区別できます。このためWPW症候群に心房細動が生じると偽性(ぎせい)心室頻拍といわれます。

　偽性心室頻拍の心室興奮頻度が高くなると心室細動(しんしつさいどう)へ移行する可能性があるので、偽性心室頻拍は早期に停止させるべきです。

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