Wolff-Parkinson-White (WPW) syndrome is a heart condition in which the heart has an extra electrical pathway. The heartbeat is abnormally fast (tachycardia) and irregular. WPW often manifests initially in people in their teens or early 20s. It’s also one of the most common causes of fast heart rate disorders in babies and children.
WPW syndrome is present at birth. The extra electrical pathway is between the atria, which are the heart’s upper chambers, and the ventricles, which are the lower chambers. The result is irregular and very rapid heart rhythms called supraventricular tachycardia.
Symptoms occur only when the heart beats abnormally fast, so most of the time people have no symptoms. Episodes can start suddenly and last for a few seconds or several hours. They often happen during exercise. When symptoms do occur, they include rapid heartbeat, heart palpitations or heart fluttering, lightheadedness, chest pain, fatigue, fainting, dizziness, anxiety, loss of consciousness, and breathing problems. Sudden death can occur.
The health care provider may suspect WPW syndrome because of the medical history. The health care provider uses electrocar-diography (ECG), which records the heart’s electrical activity. Several small electrodes are put on the chest, arms, and legs, and then the heart’s electrical pattern is recorded. The pattern shows an abnormal delta wave. The test is best done while symptoms are present. The health care provider may want other tests such as Holter monitoring. This test is a 24-hour ECG. Exercise stress testing and electrophysiology may also be done.
Treatment depends on how severe symptoms are. For very mild symptoms or those that don’t happen often, no treatment may be needed. Some people can slow the heart rate by using simple physical movements called vagal maneuvers. These include coughing, bearing down as if having a bowel movement, and putting an icepack on the face. Treatment is needed for fainting, dizziness or chest pains. A very rapid heartbeat can be life-threatening.
Treatments include drugs called antiarrhythmics. Medicines may need to be taken indefinitely. The preferred treatment is radiofrequency catheter ablation. For this treatment, a tube (catheter) is threaded through a blood vessel in the leg until it reaches the heart. Then the catheter tip provides a special kind of energy called radiofrequency waves to damage the abnormal pathways. This treatment usually stops the abnormal signals and symptoms completely. Other treatments include cardioversion and surgery. In cardioversion, the heart is shocked through paddles or patches on the chest. These methods are used when other treatments don’t work.
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