SHM Converge Scientific Abstract ePoster Gallery-Refractory Supraventricular Tachycardia in the Setting of Wolff-Parkinson-White Syndrome: An Interesting Tale

Pdf Summary

This case report describes a 57-year-old man with recurrent, refractory supraventricular tachycardia (SVT) due to left-sided Wolff-Parkinson-White (WPW) syndrome. He initially presented to an outside hospital with SVT that did not respond to repeated adenosine doses or IV fluids and was transferred for further care. At the receiving hospital, he remained persistently tachycardic despite extensive treatment including additional adenosine, beta-blockers, diltiazem, amiodarone, IV fluids, and synchronized cardioversion attempts.  <br /><br />Although he was initially hemodynamically stable, he later developed hypoxic respiratory failure and required intubation, after which he spontaneously converted to sinus rhythm. Evaluation revealed evidence of tachycardia-induced cardiomyopathy, with a drop in ejection fraction from 51% to 31–35% and global hypokinesis. He was treated in the ICU, later extubated, transferred to another facility, and ultimately underwent successful ablation of the left-sided accessory pathway. He was discharged on guideline-directed heart failure therapy.  <br /><br />The discussion emphasizes that while SVT is usually treated successfully with vagal maneuvers or adenosine, patients with WPW—especially if unstable—should be managed with cardioversion rather than AV-nodal blocking agents. Definitive treatment for WPW is catheter ablation of the accessory pathway. The case highlights the danger of refractory arrhythmias in WPW and reinforces the importance of selecting appropriate therapy based on the underlying rhythm and hemodynamic status.

Asset Subtitle

Sara Hassan

Meta Tag

Author List Saadul Mallam, Sara Hassan

Category Clinical Vignettes

Concept Supraventricular Tachycardia

Concept Wolff-Parkinson-White Syndrome

Concept Accessory Pathway Ablation

Concept Vagal Maneuvers

Concept Adenosine

Distinguished Non-Finalist

Presenter Organization Ocean University Medical Center

Presenting Author Sara Hassan

Track Adult

Keywords

Wolff-Parkinson-White syndrome

supraventricular tachycardia

refractory arrhythmia

left-sided accessory pathway

adenosine failure

tachycardia-induced cardiomyopathy

synchronized cardioversion

catheter ablation

hypoxic respiratory failure

heart failure therapy

Supraventricular Tachycardia

Wolff-Parkinson-White Syndrome

Accessory Pathway Ablation

Vagal Maneuvers

Adenosine