Is Wolff-Parkinson-White (WPW) Syndrome?
Wolff-Parkinson-White (WPW) syndrome is a birth defect in which
the heart develops an extra, or “aberrant,” electrical pathway. This can lead
to a rapid heart rate, which is called tachycardia. Medications may help
alleviate the symptoms. However, a surgical procedure called catheter ablation
is usually used to destroy the extra pathway and restore normal heart rhythm.
of WPW Syndrome
The first sign of WPW syndrome is usually a rapid heart rate.
The symptoms of WPW syndrome may occur in infants or adults. In
infants, the symptoms may include:
- severe fatigue or lethargy
- a loss of appetite
- shortness of breath
- rapid, visible pulsations of the chest
In children, teenagers, and adults, the symptoms may include:
- heart palpitations
- a racing heart
- shortness of breath or difficulty breathing
- sudden death (rarely)
In some people, the symptoms will not appear at all or will
appear only periodically in short episodes.
Causes WPW Syndrome?
Doctors aren’t sure what causes WPW syndrome. The extra
electrical pathway in the heart is present at birth, so it’s likely caused by
some abnormality that occurs during fetal development. A small percentage of people
with WPW syndrome have been found to have a gene mutation that is thought to be
responsible for the disorder.
In a normal heart, the heartbeat is initiated by the sinus node
in the upper right section of the heart muscle. This is where the electrical
impulses that start each heartbeat begin. Those impulses then travel to the
atria, or upper heart chambers, where the initiation of contraction occurs.
Another node called the atrioventricular node, or AV node, then sends the impulse
to the lower heart chambers called the ventricles where ventricular contraction
occurs and the blood is pumped out of your heart. Ventricular contraction is
much stronger than atrial contraction. The coordination of these events is
essential for maintaining a normal, regular heartbeat and rhythm.
In a heart affected by WPW syndrome, however, an extra electrical
pathway can interfere with the normal heartbeat. This extra pathway creates a shortcut
for the electrical impulses. As a result, these impulses may activate the
heartbeats too early or at the wrong time.
If it’s left untreated, the abnormal heartbeat, arrhythmia, or
tachycardia, can cause blood pressure, heart failure, and even death.
Is at Risk for WPW Syndrome?
Babies born to parents with WPW syndrome may be more at risk of
developing the condition. Babies with other congenital heart defects may also
be at a higher risk.
Is WPW Syndrome Diagnosed?
People experiencing a fluttering or racing heartbeat usually tell
their doctors. The same applies to those experiencing chest pain of difficulty
breathing. However, if you don’t have symptoms, the condition may go unnoticed
If you have a racing heartbeat, your doctor will likely perform a
physical exam and conduct tests that measure your heart rate over time to check
for tachycardia and diagnose WPW syndrome. These heart tests may include:
An electrocardiogram (EKG) uses small electrodes attached to your
chest and arms to record the electrical signals traveling through your heart.
Your doctor can check these signals for any signs of an abnormal electrical
pathway. You can also do this test at home with a portable device. Your doctor
will likely give you either an EKG device called a Holter monitor or an event
recorder that can be worn as you perform your daily activities. These monitors
can record your heart’s rhythm and rate throughout the day.
During this test, the doctor threads a thin, flexible catheter with
electrodes on its tip through your blood vessels and into various parts of your
heart, where they can map its electrical impulses.
Is WPW Syndrome Treated?
If you’re diagnosed with WPW syndrome, you have several treatment
options, depending on your symptoms. If you’re diagnosed with WPW syndrome but
don’t have any symptoms, your doctor may recommend that you wait and continue follow-up
appointments. If you’re having symptoms, the treatment may include the
The most common method of treatment, this procedure destroys the
extra electrical pathway in your heart. Your doctor inserts a tiny catheter
into an artery in your groin and threads it up into your heart. When the tip
reaches your heart, the electrodes are heated. This procedure will then destroy
the area that’s causing the abnormal heartbeat with radiofrequency energy.
Anti-arrhythmic drugs are available to treat abnormal heart rhythms.
These include adenosine and amiodarone.
If medications don’t work, your doctor may suggest cardioversion,
which involves applying an electrical shock to the heart. This can restore
normal rhythm. Your doctor will give you anesthesia to put you to sleep and
then place paddles or patches on your chest to deliver the shock. This procedure
is usually reserved for people whose symptoms aren’t relieved by other
Open-heart surgery may also be used to treat WPW syndrome but
usually only if you need surgery to treat another heart condition.
If you continue to have problems with your heart rhythm after
treatment, your doctor may implant an artificial pacemaker to regulate your
For those with mild cases of WPW syndrome, lifestyle adjustments
can help limit abnormal heart rhythms. Avoiding the following can help you
maintain a normal heartbeat:
- pseudoephedrine, which is a nasal decongestant
Your doctor may also recommend what are called “vagal maneuvers,”
which can help slow a fast heart rate. These include coughing, bearing down as though
you’re having a bowel movement, and placing an ice pack on your face.
Is the Long-Term Outlook for People with WPW Syndrome?
If you use medications to treat WPW syndrome, you may experience
unwanted side effects and you may not want to continue taking such medications in
the long term. In those cases, other treatments such as catheter ablation may
Catheter ablation is successful at curing WPW syndrome in about 80
to 95 percent of cases. Success depends on how many alternative electrical
pathways you have and where they are in your heart.
If your condition isn’t cured by catheter ablation, you still
have other treatment options, such as cardioversion or open-heart surgery. Everyone
who has the disorder will require follow-up monitoring to ensure that their
hearts are functioning normally.