What is Wolff-Parkinson-White Syndrome?

Woff-Parkinson-White Syndrome, or WPW, is named for three physicians who described a syndrome in 1930 in young people with episodes of heart racing and an abnormal pattern on their electrocardiogram (ECG). Over the next few decades, it was discovered that this ECG pattern and the heart racing was due to an extra electrical pathway in the heart. It is a type of atrioventricular reentrant tachycardia (AVRT) wherein an extra electrical pathway in the heart that allows the electrical impulses to conduct in a continuous abnormal loop (reentrant) causing a fast heart rate (tachycardia). Most people with WPW do not have any other problem with their heart.

What is WPW Syndrome as opposed to a WPW ECG?

A person has WPW Syndrome if they experience symptoms from abnormal conduction through the heart by the WPW pathway. Most commonly, the symptom is heart racing, or “palpitations”. The particular type of arrhythmia in WPW is called “supraventricular tachycardia” or SVT. “Supraventricular” means the arrhythmia requires the cells above the ventricles to be part of the abnormal circuit and “tachycardia” means fast heart rate. Some people have the WPW pattern on their ECG without having symptoms or SVT.

Effects and Symptoms

SVT may be accompanied by palpitations, dizziness, difficulty of breathing, chest pain or fainting.

Diagnosis

Children without symptoms can be diagnosed with having a WPW pattern when it is seen incidentally on ECG. Others who have symptoms may be found to have the WPW ECG pattern when they are evaluated in a clinic or when they are seen due to an episode of SVT.

Management and Treatment

You will need to discuss with your physician which of these treatment options is appropriate for you:

1. Medications: There are several medications available that can help reduce the number of episodes of WPW. If you present at a hospital with a fast heart rate, they may start an intravenous line and give medication to try to stop the heart racing.
2. Radiofrequency Catheter Ablation:  This procedure is done in the heart catheterization lab and delivers energy in a very specific way to destroy (“ablate”) the abnormal cells or pathway causing your WPW.
3. Not treating WPW is an option if the episodes are infrequent, don’t last very long, and cause few symptoms.