Wolff-Parkinson-White Syndrome in Adults: Electrocardiographic Diagnosis and Management in a Resource-Limited Setting in Kisangani, Democratic Republic of Congo (DRC)

Background: Wolff-Parkinson-White (WPW) syndrome, a rare but life-threatening arrhythmia, is underdiagnosed in sub-Saharan Africa due to limited healthcare resources. This case highlights the regional uniqueness of managing WPW in Kisangani, DRC, where diagnostic and therapeutic gaps exacerbate patient outcomes. Catheter ablation, the gold standard, remains inaccessible here, necessitating reliance on pharmacotherapy. Case Presentation: A 43-year-old woman presented with three days of sudden-onset palpitations. Electrocardiography (ECG) revealed a PR interval of 90 ms, QRS duration of 130 ms, and delta waves with positive polarity in leads II, III, aVF, and V4-V6. Echocardiography confirmed normal cardiac structure (left ventricular ejection fraction: 65%, left atrial diameter: 34 mm). She was treated with sustained-release flecainide (150 mg/day) and bisoprolol (5 mg/day), achieving symptom resolution within one week. Conclusion: Strengthening arrhythmia care in resource-limited settings requires training, technology transfer, and national registries. Long-term strategies must balance pharmacotherapy with advocacy for ablation access.