Why the study?
Perioperative drugs and factors increasing sympathetic tone can alter cardiac conduction in WPW syndrome, predisposing patients to re-entrant tachyarrhythmias, ventricular fibrillation, and sudden cardiac death.
Highlights the specific perioperative anaesthetic considerations for patients with Wolff-Parkinson-White syndrome to prevent life-threatening tachyarrhythmias.
In Wolff-Parkinson-White (WPW) syndrome, the presence of an accessory pathway between the atrium and ventricle predisposes the patient to paroxysmal supraventricular tachyarrhythmias, which may progress to ventricular fibrillation and sudden cardiac death. Several drugs that are used perioperatively may alter the cardiac conduction velocity and refractory period. This fact, interacting with factors such as increased sympathetic tone (e.g., anxiety, pain, or seizure) or haemorrhage, leads to tachycardia, where shortened R-R interval predisposes the heart to re-entrant tachyarrhythmias. We reported and highlighted the perioperative issues while anaesthetising a 15-year-old boy with WPW syndrome for craniotomy and excision of parietal meningioma.
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Leong et al. (2022) studied this question.
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