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Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome

Kozluk, Edward; Timler, Dariusz; Zysko, Dorota; Piatkowska, Agnieszka; Grzebieniak, Tomasz; Gajek, Jacek; Galazkowski, Robert and Fedorowski, Artur LU (2015) In Cardiology Journal 22(3). p.247-252
Abstract
Background: Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. Methods: The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with... (More)
Background: Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. Methods: The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with signs of pre-excitation, and who presented to the emergency team with an irregular broad QRS-complex tachycardia. Results: A total of 71 questionnaires were filled in. Only one responder recognized AF due to WPW syndrome, while 5 other responders recognized WPW syndrome and paroxysmal supraventricular tachycardia or broad QRS-complex tachycardia. About 20% of participants did not select any diagnosis, pointing out a method of treatment only. The most common diagnosis found in the survey was ventricular tachycardia/broad QRS-complex tachycardia marked by approximately a half of the participants. Nearly 18% of participants recognized WPW syndrome, whereas AF was recognized by less than 10% of participants. Conclusions: Members of emergency medical teams have limited skills for recognizing WPW syndrome with rapid AF, and ventricular tachycardia is the most frequent incorrect diagnosis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pre-excitation syndrome, Wolff-Parkinson-White (WPW) syndrome, atrial, fibrillation, Emergency Department
in
Cardiology Journal
volume
22
issue
3
pages
247 - 252
publisher
Via Medica
external identifiers
  • wos:000366307800003
  • scopus:84931331490
ISSN
1898-018X
DOI
10.5603/CJ.a2014.0086
language
English
LU publication?
yes
id
a8d6f60a-4d7f-4db0-a789-dff5b7746080 (old id 8560010)
date added to LUP
2016-02-08 07:21:48
date last changed
2017-01-01 03:30:04
@article{a8d6f60a-4d7f-4db0-a789-dff5b7746080,
  abstract     = {Background: Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. Methods: The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with signs of pre-excitation, and who presented to the emergency team with an irregular broad QRS-complex tachycardia. Results: A total of 71 questionnaires were filled in. Only one responder recognized AF due to WPW syndrome, while 5 other responders recognized WPW syndrome and paroxysmal supraventricular tachycardia or broad QRS-complex tachycardia. About 20% of participants did not select any diagnosis, pointing out a method of treatment only. The most common diagnosis found in the survey was ventricular tachycardia/broad QRS-complex tachycardia marked by approximately a half of the participants. Nearly 18% of participants recognized WPW syndrome, whereas AF was recognized by less than 10% of participants. Conclusions: Members of emergency medical teams have limited skills for recognizing WPW syndrome with rapid AF, and ventricular tachycardia is the most frequent incorrect diagnosis.},
  author       = {Kozluk, Edward and Timler, Dariusz and Zysko, Dorota and Piatkowska, Agnieszka and Grzebieniak, Tomasz and Gajek, Jacek and Galazkowski, Robert and Fedorowski, Artur},
  issn         = {1898-018X},
  keyword      = {pre-excitation syndrome,Wolff-Parkinson-White (WPW) syndrome,atrial,fibrillation,Emergency Department},
  language     = {eng},
  number       = {3},
  pages        = {247--252},
  publisher    = {Via Medica},
  series       = {Cardiology Journal},
  title        = {Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome},
  url          = {http://dx.doi.org/10.5603/CJ.a2014.0086},
  volume       = {22},
  year         = {2015},
}