What is the clinical progression of supraventricular tachycardia (SVT) in Wolff-Parkinson-White (WPW) syndrome?

Updated: Jan 08, 2017
  • Author: Christopher R Ellis, MD, FACC, FHRS; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

SVT in WPW syndrome may begin in childhood or may not appear clinically until the patient reaches middle age. The clinical course can be unpredictable, as SVT induction depends upon changes in accessory pathway and often AV node EP properties that can vary with time.

SVT due to reentry in WPW is typically orthodromic tachycardia in 95% and antidromic tachycardia in 5% (see Pathophysiology). Orthodromic SVT is usually well tolerated and not a high risk, especially in the pediatric population after young infancy. Antidromic SVT presents more frequently with dizziness and syncope. In addition, it may precipitate ventricular tachycardia and ventricular fibrillation (VF).


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