What is Wolff-Parkinson-White Syndrome?


Wolff-Parkinson-White (WPW) Syndrome was first named in 1930 after three physicians, (Wolff, Parkinson and White) who discovered a distinct electrocardiograph (ECG) pattern in healthy young people with short bursts of a rapid heart rate (tachycardia).

Wolff-Parkinson-White (WPW) Syndrome is characterized as an abnormal electrical condition in the heart that may be associated with supraventricular tachycardia (fast heart rate originating above the ventricles). Wolff-Parkinson-White (WPW) Syndrome can cause 100 or more heart beats per minute. The fast heart rate, or tachycardia, can come and go suddenly. A normal heart rate is 60-100 beats per minute. 

Wolff-Parkinson-White (WPW) Syndrome develops when an extra piece of heart muscle causes another electrical conduction pathway (called an accessory pathway) between the upper and lower chambers within your heart.  The electrical impulses of your heart then travel through both the extra pathway (short cut) as well as the normal pathway. This forces the impulses to travel around the heart very quickly, in a circular pattern, which causes the heart to beat unusually fast. Sometimes the fast heartbeat caused by Wolff-Parkinson-White (WPW) Syndrome can go back to normal on its own. Other times, treatment will be needed to manage this type of condition. 

What causes Wolff-Parkinson-White (WPW) Syndrome?

Wolff-Parkinson-White (WPW) Syndrome is a type of congenital heart abnormality that most people are born with.  The condition is not common, it is rare, occurring in approximately 1 to 3 people in a general population of 1,000. Some cases of Wolff-Parkinson-White (WPW) Syndrome are inherited.  Parents who have an accessory pathway may pass this same abnormality to their children.  In most cases, however, the condition occurs randomly in infants at birth.

What are the signs and symptoms of Wolff-Parkinson-White (WPW) Syndrome?  

People of all ages can experience Wolff-Parkinson-White (WPW) Syndrome, although it is usually diagnosed in children, adolescents, and young adults. It should be noted that about 40% of patients experience no symptoms at all.

Symptoms of Wolff-Parkinson-White (WPW) Syndrome can last a few seconds to a few hours and can include:

  • Rapid, irregular, fluttering, or pounding heart palpitations
  • Chest pain or trouble breathing
  • Dizziness or feeling like you are going to faint
  • Urinating more than usual, or heavy sweating

A percentage of people with Wolff-Parkinson-White (WPW) Syndrome can experience a more serious type of irregular heartbeat called A-fib (atrial fibrillation).  In these cases, symptoms such as chest pain, chest tightness, dizziness, and difficulty breathing may be present.

Usually, these episodes of supraventricular tachycardia (rapid heartbeats) aren’t life-threatening, but other more serious cardiac disorders can develop, and you should be evaluated by a physician.

How is Wolff-Parkinson-White (WPW) Syndrome diagnosed? 

A diagnosis of Wolff-Parkinson-White (WPW) Syndrome can be made after your physician conducts a thorough clinical evaluation, a detailed patient history, and a variety of specialized tests. These may include:

  • Electrocardiogram (EKG): An EKG measures the electrical pathways in your heart. This can show if a person has an abnormal heart rhythm or rate (arrhythmias)
  • Holter Monitor: This is a portable EKG monitoring system. It shows your heart’s electrical activity while you do your usual every day activities. It will show the doctor how fast your heart beats and if it is beating in a regular pattern. This monitor is a small battery-powered device that you wear for the amount of time the doctor has prescribed. 
  • Electrophysiologic Studies (EPS): EPS tests the electrical activity of your heart.

Some people with Wolff-Parkinson-White (WPW) Syndrome may be clinically "silent" meaning that they have no symptoms associated with the disorder including no abnormal findings on various heart tests.

How is Wolff-Parkinson-White (WPW) Syndrome treated?

Treatment for Wolff-Parkinson-White (WPW) Syndrome depends on how severe the  symptoms are and how often the symptoms occur. Some treatments can stop the episodes of fast heart beats (tachycardia) while other treatments can prevent episodes from happening in the future. Treatments can include:

  • Vagal maneuvers:  Coughing or “bearing down”. These maneuvers help stimulate the vagus nerve which helps control your heart beat. 
  • Medicine.  Medicines can be prescribed by doctors to slow or regulate your heartbeat. 
  • Radiofrequency ablation:  This procedure sends energy to the area of your heart that has an electrical problem. The energy causes an area of the heart muscle to scar. This stops the electrical problem and allows your heart to beat normally. 
  • Cardioversion: A procedure used to give your heart an electrical shock to stop the fast heartbeat (tachycardia). This will put your heartbeat back into a normal rhythm.
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