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Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White Syndrome

In Wolff-Parkinson-White syndrome, there is an extra electrical pathway in the heart — an abnormal bridge of heart muscle fibers that connects the upper chambers of the heart to the lower chambers. This extra pathway may allow electrical impulses to travel rapidly in the heart, causing an abnormally fast heartbeat, a form of supraventricular tachycardia. The extra electrical pathway may be seen on an electrocardiogram (EKG or ECG), causing an abnormal pattern known as a delta wave. In rare cases, the heart rhythm can be extremely rapid and potentially dangerous.

The "normal" number of heartbeats per minute, called pulse rate, varies with age. The heart beats about 140 times a minute in a newborn, compared to 70 times a minute in an older child at rest. Heart rate is not constant, changing in response to many factors, such as activity, fever and fear. With Wolff-Parkinson-White syndrome, the heart beats too quickly — up to 300 beats per minute. The heart cannot fill completely with blood, preventing the body from receiving the blood volume it needs to function properly.


Congenital

Some cases of WPW are inherited. Parents who have accessory pathways may pass them on to their children. One paper suggested the incidence of preexcitation in first-degree relatives could be as high as 5.5 per 1,000 persons. About 7 to 20 percent of patients with WPW also have congenital defects within the heart.

What are the symptoms of WPW?

Most people experience symptoms between the ages of 11 and 50 years old.

Symptoms of WPW may include one or more of the following:

  • Heart palpitations – a sudden pounding, fluttering or
  • Racing feeling in your chest
  • Dizziness – feeling lightheaded or faint
  • Shortness of breath (dyspnea)
  • Anxiety
  • arely, cardiac arrest (sudden death)

Some people have WPW without any symptoms at all.

How is WPW diagnosed?

WPW is diagnosed by reviewing the results of several tests:
  • ECG (electrocardiogram)
  • Holter monitor
  • Exercise testing
  • Electrophysiology testing

These tests help the doctor learn if you are have ECG findings of WPW and presence of accessory pathways.

Your doctor will also ask you several questions:
  • Do you have symptoms?
  • Do you have a history of atrial fibrillation?
  • Do you have a history of fainting?
  • Do you have a history of sudden cardiac death or does anyone in your family?
  • Are you a competitive athlete?

The results of your diagnostic tests and the answers to these questions will help guide your therapy.

How is Wolff-Parkinson-White syndrome treated?

Treatment depends on the type of arrhythmias, the frequency and the associated symptoms.

  • Observation - If you have no symptoms, you may not require treatment. Your doctor may choose to have regular follow-up without treatment.
  • Medications - A variety of drugs are available to treat arrhythmias. Because everyone is different, it may take trials of several medications and doses to find the one that works best for you.

It is important to know:

  • The names of your medications
  • What they are for
  • How often and at what times to take them
Ablation

In people with WPW, whose heart rate can not be controlled with medications, ablation can improve symptoms and cure the abnormal arrhythmias. During ablation, high-frequency electrical energy is delivered through a catheter to “disconnect” the abnormal pathways.

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