What is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White (WPW) syndrome means that there is an extra electrical pathway in the heart that can cause a very fast heartbeat. An electrical signal in your heart starts each heartbeat, causing the heart muscle to squeeze (contract). Normally, this signal starts in the upper right chamber of the heart (the right atrium) at a place called the sinus node. The signal then follows pathways to the upper left atrium and to the lower chambers of the heart (the ventricles).

In WPW, the extra electrical pathway can cause the heart to beat over 200 times a minute. This may happen only a few times in a person’s life, or it may happen as often as once or twice a week.

WPW may cause symptoms as early as the first year of life or not until you are an adult.

What is the cause?

People with WPW are born with an extra electrical pathway. Usually a person with WPW does not have other heart problems, but some people may have other heart defects. Heart defects may be inherited, which means that that they are passed from parents to children through their genes. Genes are inside each cell of your body. They contain the information that tells your body how to develop and work.

What are the symptoms?

You may have no symptoms. If your heart starts beating very fast, it may cause:

• A thumping, pounding, or racing feeling in the chest or neck
• Lightheadedness or dizziness
• Weakness
• Shortness of breath
• Sweating
• Chest pain
• Fainting

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat. You may be asked to wear a small portable ECG monitor for a few days or longer.
• Electrophysiologic study (EPS), which uses tiny wires put into your heart through your veins to look at the electrical pathways in your heart
• Echocardiogram, which uses sound waves (ultrasound) to show the structures of the heart and how well the heart is pumping
• Angiogram, which is a series of X-rays taken after your healthcare provider injects a special dye into your blood vessels to check the structure of the heart
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the heart and blood vessels

How is it treated?

Your treatment depends on how often you have symptoms and the severity of your symptoms. You may not need treatment if:

• You rarely have a fast heartbeat.
• It doesn’t last long.
• It doesn’t cause serious symptoms.

If you need treatment to help your heart stay in a normal rhythm, possible treatments are:

• Medicine to control the heart rate
• Electrical cardioversion: First, you will be given medicine called anesthesia to keep you from feeling pain during the procedure. Then your chest will be given an electrical shock. The electrical shock should make your heart start beating normally again. You may need medicine to keep your heart rhythm normal after this procedure.
• Ablation: Ablation is a procedure that uses a small tube called a catheter to deliver energy to the inside of the heart. The energy (usually radio waves) scars small areas of heart tissue. The scars block abnormal electrical pathways and help you have a normal heart rhythm. With some types of ablation treatment, you will also need a pacemaker. A pacemaker is an electronic device put under the skin of your chest to help control the heartbeat.

How can I take care of myself?

Follow your healthcare provider’s instructions. Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities or professions (such as an airline pilot) you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.