Wolff-Parkinson-White syndrome: anaesthetic care for meningioma excision

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.