WPW SYNDROME-A Case Report

WPW syndrome is Wolff Parkinson's White Syndrome, a type of pre-excitation syndromecaused by the accessory pathway joining atria and ventricle other than the normal atrio- ventricular pathway. It is characterized by the presence of short PR interval and Delta waves in QRS complexwith widening of QRS complex in ECG. Preoperatively, there is no way to determine the presence of accessory AV conduction pathway in the presence of normal ECG tracing. Managing the case through preoperative history and clinical evaluation is very important. If the patient has been asymptomatic, then chances of life threatening arrhythmias are less but if patient is symptomatic then chances of arrhythmias especially under anaesthesia are highly increased. The facts of unmasking of WPW syndrome under anaesthesia has been mentioned in the lieratures. Anesthetic drugs tend to change the physiology of the atrioventricular conduction. We report a known case of WPW syndrome that was asymptomatic preoperatively except for an abnormal ECG with delta wave, posted for Hemi thyroidectomy. These patients are very prone forarrhythmias especially PSVT. Even asymptomatic patients can develop arrhythmias, at any time during surgery so meticulous monitoring should be done in the perioperative period.