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Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White Syndrome (WPW) is a potentially life-threatening condition in which the heart’s electrical signals travel along an extra pathway from the heart’s upper chambers (atria) to the lower chambers (ventricles). This extra pathway disrupts the timing of the heart’s electrical signals and can cause the ventricles to beat very fast. WPW may be associated with supraventricular tachycardia (fast heart rate originating above the ventricles). Although rare, the greatest concern for people with WPW is the possibility of having atrial fibrillation (AFib) with a fast ventricular response that worsens to ventricular fibrillation (VFib), a life-threatening arrhythmia.

Wolff-Parkinson-White Syndrome Causes and Risk Factors

WPW is a congenital heart abnormality; the extra electrical pathway is present at birth. WPW occurs randomly in the general population, in about 1 to 3 of 1,000 persons. Males are more prone than females to have this heart disorder. Some cases of WPW are inherited. WPW may be associated with congenital cardiac defects, Ebstein's anomaly, mitral valve prolapse, hypertrophic cardiomyopathy or other cardiomyopathies (diseases of the heart muscle).

Symptoms of Wolff-Parkinson-White Syndrome

Symptoms of WPW may include one or more of the following:

  • Heart palpitations – a sensation of rapid, fluttering or pounding heartbeats
  • Dizziness – feeling lightheaded or faint
  • Shortness of breath
  • Fatigue
  • Anxiety
  • Rarely, cardiac arrest (sudden death)

Some people have WPW without any symptoms at all.

Diagnosing Wolff-Parkinson-White Syndrome

Your doctor will likely recommend heart tests to diagnose WPW syndrome, such as:

  • Electrocardiogram (ECG) – a non-invasive test in which a machine records the electrical activity of your heart with a pen and graph paper. The doctor studies the shapes of these lines to check for any changes in the normal rhythm, including patterns that indicate the presence of an extra electrical pathway in your heart.
  • Portable ECG/Holter monitor – a portable device worn by a patient throughout his or her normal activities, to show changes in rhythm that may not be detected during a regular ECG
  • Electrophysiology (EP) – a test for arrhythmia in which doctors insert a thin tube called a catheter into a blood vessel that leads to the heart. A specialized electrode catheter designed for EP studies lets them send electrical signals to the heart and record its electrical activity. 

Treating Wolff-Parkinson-White Syndrome

Treatment for patients with WPW  depends on the severity and frequency of symptoms. If a patient exhibits no symptoms, likely no treatment will be required. If a patient exhibits symptoms, treatment to slow a fast heart rate and to prevent future episodes might be needed.

Treatments might include:

  • Vagal maneuvers – techniques used to try to slow an episode of fast heart rate by stimulating the vagus nerve, including pressing gently on the eyeballs with eyes closed, holding your nostrils closed while blowing air through your nose (Valsalva maneuver) or immersing your face in ice-cold water (diving reflex). These maneuvers should be guided by your doctor. 
  • Antiarrhythmic medications -- including beta-blockers or calcium channel blockers
  • Electrical cardioversion or heart ablation -- may be needed in cases of ongoing or recurring arrhythmia

Getting Started

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