Heart & Stroke Conditions Explained

Definition

Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White syndrome (commonly known as WPW) is a condition where an extra conduction (electrical) pathway, called an accessory pathway, connects the upper and lower chambers (atria and ventricles) of the heart.

Normally, there is just one electrical pathway connecting these chambers and impulses which generate the heartbeat pass in only one direction (upper to lower).

The extra pathway may allow the normal electrical signal to arrive at the ventricles more quickly than usual, causing “pre-excitation” and producing characteristic changes on the electrocardiogram (ECG).

Symptoms

Wolff-Parkinson-White Syndrome

The extra pathway may at times function as a “short-circuit”, allowing impulses to circulate rapidly down the normal pathway and back up the accessory pathway causing the heart to suddenly beat abnormally fast, in an abnormal heart rhythm called supraventricular tachycardia (SVT). This may last for a few minutes or can persist for several hours.

Should this symptom happen the person will complain of rapid heart beating and may experience palpitations, dizziness, chest tightness and may even faint. Episodes can often begin during exercise.

The most serious situation, which is fortunately very rare, is when people with WPW develop atrial fibrillation (very rapid, irregular, chaotic electrical activity within the atria) which may travel very rapidly down the accessory pathway to the ventricles. This may then cause ventricular tachycardia or fibrillation and cardiac arrest.

Other people with WPW may never have SVT or other symptoms. About 80 percent of people with symptoms, first experience them between the ages of 11 and 50.

Causes

Wolff-Parkinson-White Syndrome

This extra pathway is present at birth but may only become apparent as you get older. It is fairly rare and little is known about why it develops.

 

Prevention

Wolff-Parkinson-White Syndrome

If treatment is needed, the goal is to slow a fast heart rate when it occurs and to prevent future episodes.

 

Diagnosis

Wolff-Parkinson-White Syndrome

An ECG (electrocardiogram) is used to record the rhythm and electrical activity of your heart.

People with WPW usually have a distinctive pattern on the ECG tracing called a ‘delta wave’ which does not appear in people who don’t have the condition.

Your doctor will take a history of any symptoms you have experienced and will likely recommend some further heart tests which may include: a holter monitor to record a 24 hour ECG; an event recorder for a longer period of monitoring which you can activate when symptoms occur; electrophysiology study which will confirm the diagnosis and locate the extra pathway.

Treatment

Wolff-Parkinson-White Syndrome

People who do not have symptoms may not require treatment unless the extra pathway poses a risk to them or if they have special occupations such as airline pilot

People who have episodes of SVT can be treated with long-term medication or can undergo radiofrequency catheter ablation which is curative in 95 to 98% of cases.

Whether an individual will be treated with medication or by an ablation procedure depends on several factors such as the severity and frequency of symptoms, risk for future arrhythmias and patient preference.

Once the condition has been identified and treated appropriately, people with WPW syndrome have an excellent prognosis.

Resources

Wolff-Parkinson-White Syndrome

Read our resources for further information:

For more about heart conditions, from diagnosis to prevention and treatment, view our Heart Conditions Explained articles such as: atherosclerosisanginaheart attack and stroke.

You can also contact our helpline nurses on Freephone 1800 25 25 50 Mon – Fri 9am – 5pm, Thurs till 7pm

 

 

Symptoms