Wolff-­Parkinson-­White Syndrome

Wolff-Parkinson-White Syndrome (WPW)
Wolff-Parkinson-White Syndrome (WPW)

The Wolff-Parkinson-White (WPW) syndrome belongs to the heart rhythm disturbances. A typical symptom of this disease is rapid heartbeat (tachycardia) caused by an extra electrical pathway between the heart's upper and lower chambers. Almost all affected people experience the WPW syndrome for the first time between the ages of 11 and 50. Although the episodes of fast heartbeats normally aren't life-threatening, serious heart problems can occur. An ablation may permanently correct cardiac arrhythmia.

Symptoms of WPW syndrome

Episodes mostly occur during exercise.  All of a sudden, the heart starts beating very fast. This condition may last a few seconds or several hours. Caffeine or alcohol might be a trigger for some patients. In the course of time, symptoms of WPW can disappear in about 25 percent of people who experience them.

Symptoms may be:

  • (Heart) arrhythmia
  • Sensation of rapid or pounding heartbeats (tachycardia)
  •  Feeling of giddiness
  • Lightheadedness
  • Fainting
  • Tiring easily during exercise
  •  Respiratory distress
  •  Anxiety

Children with WPW syndrome may suffer from loss of appetite, poor concentration and developmental delay.

Symptoms in more serious cases

10 to 30 percent of the patients with Wolff-Parkinson-White syndrome may also experience atrial fibrillation that steadily increases after age 50, and shows the following symptoms:

  • Chest pain
  • Chest tightness
  • Respiratory distress

If a patient shows any of the following symptoms for more than a few minutes, he/she should call the emergency doctor or ambulance immediately:

  • Irregular or rapid heartbeat
  • Breathing difficulties
  • Chest pain

Causes and origin of WPW syndrome

There are different kinds of heart arrhythmias. Many of them arise because of some kind of "short circuit" in the heart: The affected people have an extra electrical pathway between atria and ventricles that transmits electrical impulses, and in this way causes palpitation. The most common heart rhythm disturbance is the Wolff-Parkinson-White (WPW) syndrome that seems to be more common in men than in women. Symptoms such as palpitation most often occur in teenagers.

But, in general, there is only little information about the development of this extra pathway. But the following facts have been proven: The pathway is already present at birth, and an abnormal gene causes it in a small percentage of people with the WPW syndrome. WPW is also associated with some forms of congenital heart disease.

Consequences of WPW syndrome

The most severe form of a rapid heartbeat is ventricular fibrillation. This condition may quickly lead to shock or death.
Ventricular fibrillation requires emergency treatment and “cardioversion”, a procedure by which an abnormally fast heart rate or cardiac arrhythmia is converted to a normal rhythm using electricity or medication.

Prevention and therapy of WPW syndrome

It is necessary to get a prompt, accurate diagnosis and appropriate care if symptoms appear that are associated with WPW syndrome.The most important test for the diagnosis of cardiac arrhythmias is the electrocardiogram (ECG) that shows the heart rhythm and the flow of electrical excitation in the heart as typical curves. An ECG during palpitation is very conclusive. However, some changes can also be identified in intervals without tachycardia. Usually, a long-term ECG is performed. Affected people that already know they have WPW syndrome should inform the physician in order to find the right medication for this special condition.

Tachycardia attack

In case of acute attacks of tachycardia, the aim of the treatment is to stop and prevent new attacks. If an attack happens at home, initial measures, such as drinking cold water, sometimes stop palpitation. But a doctor’s visit is needed as soon as possible. The physician may interrupt the arrhythmia by administering an antiarrhythmic agent called Ajmaline directly into the vein. The acute treatment of cardiac arrhythmias requires strict and constant monitoring by ECG. A catheter ablation of the accessory pathway – often used as long-term treatment for WPW syndrome – can also prevent new tachycardia attacks.

Open heart surgery is done only if the patient needs heart surgery for other reasons.