What is the clinical evidence from this study?

Study design: Case Report. Population: Wolff-Parkinson-White syndrome with paroxysmal atrial fibrillation (n=1). Intervention: Medical management (sotalol and rivaroxaban). Primary outcome: Resolution of atrial fibrillation and diagnosis of WPW.

What does this research mean for the field?

Paroxysmal atrial fibrillation with pre-excitation can serve as the initial presentation of Wolff-Parkinson-White syndrome, posing a life-threatening risk of degenerating into ventricular fibrillation if atrioventricular nodal blockers are administered. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To report a case of paroxysmal pre-excited atrial fibrillation as the initial manifestation of Wolff-Parkinson-White syndrome in a young adult and discuss clinical challenges in resource-constrained settings.

October 5, 2026Health sciences and diseaseOpen Access

Fibrillation Atriale Paroxystique Révélant un Syndrome de Wolff-Parkinson-White chez un Sujet Jeune : Paroxysmal atrial fibrillation revealing a Wolf-Parkinson-White syndrome in a young patient

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Key result

Paroxysmal AF can herald underlying WPW syndrome, requiring avoidance of AV nodal blocking agents.

Why the study?

Paroxysmal atrial fibrillation with pre-excitation can be the initial presentation of Wolff-Parkinson-White syndrome and its management has several limitations in certain settings.

Key Points

To report a case of paroxysmal pre-excited atrial fibrillation as the initial manifestation of Wolff-Parkinson-White syndrome in a young adult and discuss clinical challenges in resource-constrained settings.
Documented the clinical presentation, diagnosis, and electrocardiographic evolution of a 29-year-old male presenting with acute palpitations at Hôpital Général de Yaoundé.
Evaluated electrocardiographic markers differentiating accessory pathway pre-excitation from atrial fibrillation with aberrant ventricular conduction.
Per-critical electrocardiogram demonstrated wide, accordion-like QRS complexes, which converted spontaneously to sinus rhythm showing classic pre-excitation signs including a short PR interval and delta waves.
Inappropriate administration of atrioventricular nodal blocking drugs, such as beta-blockers, digoxin, or amiodarone, poses an acute risk of inducing 1:1 conduction and degeneration into ventricular fibrillation.
Curative catheter ablation of the accessory pathway achieves a cure rate exceeding 90%, but local unavailability of ablation facilities and class Ia or Ic antiarrhythmics necessitates costly medical evacuations.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A 29-year-old man with no prior cardiovascular history presenting with paroxysmal atrial fibrillation revealing Wolff-Parkinson-White syndrome.

Intervention

Enoxaparin (100 IU/kg) and atenolol (50 mg) initially planned, but crisis resolved spontaneously. Discharged on sotalol 40 mg twice daily and rivaroxaban for 4 weeks, pending radiofrequency ablation.

Outcome

Resolution of atrial fibrillation and diagnosis of WPW syndrome.

Paroxysmal atrial fibrillation can be the inaugural presentation of WPW syndrome, requiring careful ECG interpretation to avoid potentially fatal administration of AV nodal blocking agents.

Limitations

Unavailability of class Ia and Ic antiarrhythmics and ablation therapies in the local setting
Unavailability of electrophysiological explorations and ablative techniques locally
Unavailability of class IA and IC antiarrhythmics locally

Implication

Alerts clinicians to screen young paroxysmal AF for pre-excitation; leaves open optimal management where ablation remains unavailable.

Abstract

RÉSUMÉLa fibrillation atriale paroxystique sur faisceau-accessoire (pré-excitée), peut constituer la présentation inaugurale d’un syndrome de Wolff-Parkinson-White. C’est une affection souvent mal tolérée, pouvant rapidement engager le pronostic vital, et dont la prise en charge souffre de nombreuses limites dans notre contexte. La méconnaissance de ses spécificités diagnostique et thérapeutique peut conduire à la prescription de bloqueurs du nœud auriculo-ventriculaire, potentiellement responsables d’une dégénérescence en fibrillation ventriculaire. ABSTRACTParosysmal atrial fibrillation with pre-excitation (accessory pathway), can be the earliest presentation of the wolf- parkinson-white syndrome. It is usually poorly tolerated by the patient, severe enough to impair vital prognosis. The management of this condition has several limitations in our setting. The unawareness of diagnostic and therapeutic particularities concerning this condition can lead to prescription of atrioventricular nodal blocking drugs in these patients which can result in ventricular fibrillation.

Discussion

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Cite This Study

Jérôme et al. (2021) conducted a case report in Wolff-Parkinson-White syndrome with paroxysmal atrial fibrillation (n=1). Medical management (sotalol and rivaroxaban) was evaluated on Resolution of atrial fibrillation and diagnosis of WPW. Paroxysmal atrial fibrillation can be the inaugural presentation of Wolff-Parkinson-White syndrome in a young patient, requiring careful management to avoid atrioventricular nodal blocking drugs.

synapsesocial.com/papers/6ac2fd087180a622ddd4df12 https://doi.org/10.5281/hsd.v22i8.2912

Topics

Atrial fibrillation

Persistent AF management

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Implication

Alerts clinicians to screen young paroxysmal AF for pre-excitation; leaves open optimal management where ablation remains unavailable.

Fibrillation Atriale Paroxystique Révélant un Syndrome de Wolff-Parkinson-White chez un Sujet Jeune : Paroxysmal atrial fibrillation revealing a Wolf-Parkinson-White syndrome in a young patient

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Fibrillation Atriale Paroxystique Révélant un Syndrome de Wolff-Parkinson-White chez un Sujet Jeune : Paroxysmal atrial fibrillation revealing a Wolf-Parkinson-White syndrome in a young patient

Key Points

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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