Wolff-Parkinson-White syndrome

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MEDLINEplus Medical Encyclopedia: Wolff-Parkinson-White syndrome Wolff-Parkinson-White syndrome

Contents of this page:

Illustrations

Alternative names

Definition

Causes and risks

Prevention

Symptoms

Signs and tests

Treatment

Prognosis

Complications

Call your health care provider if

Illustrations

Conduction system of the heart

Alternative names Return to top

Preexcitation syndrome; WPW Definition Return to top

A syndrome involving episodes of rapid heart rate (tachycardia) caused by abnormal electrical pathways (circuits) in the heart. Causes and risks Return to top

Normally, the electrical stimulus of the heart travels through the atria and then through the atrioventricular (AV) node where it is delayed before continuing into the ventricles.

Wolff-Parkinson-White is a condition where there is an extra (accessory) atrioventricular conduction pathway. The extra pathway bypasses the normal conduction delay of the AV node and it may cause a form of "supraventricular tachycardia" (a rapid heart rate that is initiated above the ventricles) called reentry. The extra pathway in Wolff-Parkinson-White can often be located precisely.

Wolff-Parkinson-White occurs in approximately 4 out of 100,000 people, and is one of the most common causes of tachyarrhythmia (fast heart rate disorder) in infants and children.

The frequency of these episodes of rapid heart rate varies from person to person. Patients with Wolff-Parkinson-White have isolated episodes of the arrhythmia -- "frequent" episodes would be those occurring once or twice a week. Many Wolff-Parkinson-White patients never have arrhythmia, are completely free of symptoms, and their condition is discovered by reviewing an ECG requested for some other purpose.

Prevention Return to top

unknown Symptoms Return to top

palpitations (a sensation of feeling your heart beat)

light headedness

fainting

dizziness

shortness of breath

chest pain or chest tightness Signs and tests Return to top

An examination during the tachyarrhythmia will reveal a heart rate greater than 150 (normal is 60 to 100 beats per minute), and a blood pressure that is normal or low. If a tachyarrhythmia is not present, the physical exam may be completely normal.

Wolff-Parkinson-White syndrome may be revealed by the following tests:

ECG (electrocardiogram), which looks for a finding called a "delta wave"

continuous ambulatory monitoring (Holter monitor), which may record an episode of arrhythmia

EPS, an intracardiac electrophysiologicstudy showing the accessory pathway Treatment Return to top

The goal of treatment is to reduce symptoms by reducing the episodes of tachycardia (rapid heart rate).

Medication may be used to control or prevent tachycardia episodes, including adenosine, antiarrhythmics, and amiodarone. Digoxin, verapamil, and beta-blockers (other drugs commonly used to treat tachycardia) can increase the frequency of tachycardia episodes for some people with Wolff-Parkinson-White.

Other treatments to stop a persistent episode of tachycardia may include electrical cardioversion (shock) or occasionally pacemakers designed to interrupt the reentry cycle.

Surgery may provide a permanent cure for Wolff-Parkinson-White. It involves destruction (ablation) of the accessory pathway through open heart surgery. Surgery may be a good approach to cure Wolff-Parkinson-White if the patient must undergo surgery for other reason.

Prognosis Return to top

The outcome varies. Using a catheter that delivers radiofrequency to destroy the abnormal pathway usually cures Wolff-Parkinson-White. This is currently the preferred therapeutic approach to treat Wolff-Parkinson-White syndrome in the US. Complications Return to top

reduced blood pressure caused by sustained rapid heart rate. The most severe form of tachyarrhythmia is atrial fibrillation, which may rapidly lead to shock and thus requires emergency treatment (i.e., cardioversion).

heart failure

side effects of medications used to treat Wolff-Parkinson-White (see the specific medication)

complications of surgery Call your health care provider if Return to top

Call your health care provider if symptoms indicate Wolff-Parkinson-White may be present, or if you have this disorder and symptoms worsen or do not improve with treatment.

Update Date: 02/01/01

Updated by: Elena Sgarbossa