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 raise the risk of sudden death.
WPW happens when the heart's signals travel along an extra and 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.
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Rarely, WPW syndrome is found in families. Otherwise, there are no known risk factors.
Some people with WPW syndrome have no symptoms. In those who do, symptoms may be:
- Fast heartbeats that start and stop suddenly
- Pounding heartbeats
- Chest pain or tightness
- Problems breathing
Rarely, a person will go into cardiac arrest and lose consciousness.
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:
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. Defibrillation can give the heart a brief shock if this happens. This changes the fast abnormal heartbeats to normal heartbeats.
There are no known guidelines to prevent WPW syndrome.
- 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.
- Cardiac bypass tracts. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cardiac-bypass-tracts.
- 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 website. Available at: https://www.nhlbi.nih.gov/health/wolff-parkinson-white-syndrome.
- Nicole Meregian, PA
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