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Wolff-Parkinson-White Syndrome

(WPW)

by Amy Scholten, MPH

Home | Health Information Center | Disease, Condition, & Injury Fact Sheets | Article

Definition

Wolff-Parkinson-White syndrome (WPW) is a problem with the heart’s electrical activity. It causes the heart to beat with an irregular rhythm and faster than normal. This is called tachyarrhythmia. If left untreated, it can increase the risk of sudden death.

Causes

WPW happens when the heart's signals travel along an extra, abnormal pathway. The signals make the lower chamber of the heart contract abnormally. As a result, the heart beats much faster than it should.

The extra pathway is caused by abnormal tissue that connects the heart’s chambers. The tissue forms before birth.

It is not clear what causes this to happen. Rarely, it may be due to a gene that is inherited.

Electrical Conduction System of the Heart

Risk Factors

Rarely, WPW syndrome is found in families. Otherwise, there are no known risk factors.

Symptoms

Some people with WPW syndrome have no symptoms. In those that do, symptoms may be:

Fast heartbeats that start and stop suddenly
Pounding heartbeats
Chest pain or tightness
Lightheadedness
Fainting
Problems breathing

Rarely, a person will go into cardiac arrest and lose consciousness.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Tests will be done to diagnose the condition. They may include:

Electrocardiogram (ECG)—tests electrical activity of the heart
Holter monitoring—a device worn to measure heart activity over 24 to 48 hours
Electrophysiology study—wires are passed into the heart to measure activity and find the extra pathway

Treatment

People without symptoms may not need treatment. For those who do have symptoms, the goal is to slow the fast heartbeats. It is also to ease or stop other symptoms.

Options may be:

Medicine to regulate the heart signals
Radiofrequency ablation—a procedure where heat is used to destroy the abnormal pathway
Open heart surgery—(rarely done) to destroy the abnormal pathway

Rarely, cardiac arrest happens. In this case, defibrillation gives the heart a brief shock. This changes the fast, abnormal heartbeats to normal heartbeats.

Prevention

There are no known guidelines to prevent WPW syndrome.

RESOURCES:

American Heart Association
http://www.heart.org/

Heart Rhythm Society
http://www.hrsonline.org/

CANADIAN RESOURCES:

Canadian Heart Rhythm Society
http://www.chrsonline.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

References:

Atrial fibrillation and Wolff-Parkinson-White syndrome. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/cardiovascular-disorders/arrhythmias-and-conduction-disorders/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw. Accessed September 14, 2021.

Cardiac bypass tracts. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cardiac-bypass-tracts. Accessed September 14, 2021.

De Ponti R, Bagliani G, et al. Change of paradigm in the management of patients with accessory pathways over the last forty years: Wolff-Parkinson-White Syndrome as an electrophysiological marvel at risk of extinction. Card Electrophysiol Clin. 2020;12(4):431-436.

Wolff-Parkinson-White syndrome. National Heart, Lung and Blood Institute. Available at: https://www.nhlbi.nih.gov/health-topics/wolff-parkinson-white-syndrome. Accessed September 14, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Nicole Meregian, PA
Last Updated: 9/14/2021

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