title: Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome.
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.
authors.forename: Edward
authors.initials: E
authors.lastname: Koźluk
authors.forename: Dariusz
authors.initials: D
authors.lastname: Timler
authors.forename: Dorota
authors.initials: D
authors.lastname: Zyśko
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Piątkowska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grzebieniak
authors.forename: Jacek
authors.initials: J
authors.lastname: Gajek
authors.forename: Robert
authors.initials: R
authors.lastname: Gałązkowski
authors.forename: Artur
authors.initials: A
authors.lastname: Fedorowski
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D002983:Clinical Competence; D003951:Diagnostic Errors; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011237:Predictive Value of Tests; D011379:Prognosis; D011795:Surveys and Questionnaires; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy