Wolff-Parkinson-White Syndrome

Conditions Basics

What is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White (WPW) syndrome is a heart rhythm problem that causes a very fast heart rate. WPW is one type of supraventricular tachycardia called atrioventricular reciprocating tachycardia (AVRT).

With WPW, an extra electrical pathway links the upper chambers (atria) and lower chambers (ventricles) of the heart. In normal hearts, the only electrical connection between the atria and ventricles is through the AV node. The AV node helps control the heartbeat. In WPW, the extra electrical pathway is called a bypass tract because it bypasses the AV node. So the AV node cannot control the heartbeat, and so it beats very fast.

People with WPW are more likely to have atrial fibrillation or atrial flutter. When they do, the electrical impulses can travel down the bypass tract and cause the heart to beat at rates of more than 250 to 300 times per minute. This may result in fainting (syncope) or cause sudden death.

What causes it?

Many experts believe that Wolff-Parkinson-White syndrome may in some cases be inherited.

If you have a first-degree relative, which is a parent, brother, or sister, with this disorder and they have symptoms, talk with your doctor about your risk for this abnormal heart rhythm.

What are the symptoms?

Symptoms of Wolff-Parkinson-White syndrome (WPW) include the sense of feeling the heart beat rapidly (palpitations), lightheadedness, fainting, chest pain, and dizziness.

Some people do not have symptoms.

Episodes of WPW can trigger a life-threatening heart rhythm called ventricular fibrillation, although this is extremely rare. Your doctor may recommend that you wear medical alert jewelry to alert medical professionals of your condition if you are at risk for ventricular fibrillation.

How is it diagnosed?

Doctors can often diagnose Wolff-Parkinson-White (WPW) syndrome by using an electrocardiogram (EKG or ECG). On EKG in WPW, the electrical preexcitation of the ventricles can be seen as an abnormality on the EKG known as a delta wave.

How is Wolff-Parkinson-White Syndrome treated?

During an episode of Wolff-Parkinson-White syndrome (WPW), your doctor may suggest that you try vagal maneuvers. These are things that might help slow your heart rate. Your doctor will teach you how to do vagal maneuvers safely. Examples include bearing down or putting an ice-cold, wet towel on your face.

If an episode needs emergency treatment, you might have a procedure called electrical cardioversion to reset your heart rhythm. Or you may get a fast-acting medicine to slow your heart rate.

The goals of long-term treatment are to prevent episodes, relieve symptoms, and prevent future problems. You and your doctor can decide what type of treatment is right for you. Your options may include medicines or a procedure called catheter ablation.