WOBBLER Syncope ECG Asessment

2 Views

  • Thanks! Share it with your friends!

    You disliked this video. Thanks for the feedback!

admin
Published
Homepage: EMNote.org ■
????Membership: https://tinyurl.com/joinemnote
????ACLS Lecture: https://tinyurl.com/emnoteacls

WOBBLER Mnemonic for Syncope Assessment

Introduction to WOBBLER Mnemonic for Syncope
- Syncope (fainting) is a common emergency presentation with potentially life-threatening causes.
- WOBBLER is a mnemonic for evaluating ECGs in syncope patients without obvious ischemia or dysrhythmia.
- Helps identify critical but less common ECG abnormalities associated with syncope.

What Does WOBBLER Stand For?
- W: Wolff-Parkinson-White Syndrome (WPW)
- O: Obstructed AV Pathway
- B: Bifascicular Block
- B: Brugada Syndrome
- L: Left Ventricular Hypertrophy (LVH)
- E: Epsilon Wave
- R: Repolarization Abnormality

Wolff-Parkinson-White Syndrome (WPW)
- Accessory electrical pathway bypassing the AV node.
- ECG findings: Short PR interval (less than 120 ms) and delta wave at QRS onset.
- Increases risk of tachyarrhythmias.

Obstructed AV Pathway & Bifascicular Block
- Obstructed AV Pathway: Look for second-degree (Mobitz type II) or third-degree heart block.
- Bifascicular Block: Affects two of three major fascicles (e.g., right bundle branch block + left anterior/posterior fascicular block).
- May cause widened QRS complexes.

Brugada Syndrome & Left Ventricular Hypertrophy (LVH)
- Brugada Syndrome: Coved ST-segment elevation in leads V1-V3; high risk of sudden cardiac death.
- LVH: Consider hypertrophic cardiomyopathy (HOCM) and aortic stenosis.
- Can cause exertional syncope due to left ventricular outflow tract obstruction.

Epsilon Wave & Repolarization Abnormality
- Epsilon Wave: Small positive deflections after QRS in V1-V3; associated with arrhythmogenic right ventricular cardiomyopathy (ARVC).
- Repolarization Abnormality: Prolonged QT interval (more than 500 ms) indicates long QT syndrome, risking torsades de pointes and sudden death.

Practical Application of WOBBLER
- Systematically evaluate each ECG component from P wave to T wave.
- Use WOBBLER when no obvious ischemic changes or dysrhythmias are present.
- Correlate ECG findings with clinical history and additional tests (e.g., echocardiography).
- Rare but life-threatening conditions can be missed without systematic evaluation.
Category
Cardiology
Be the first to comment

Up Next