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Wolff-Parkinson-White (WPW) Syndrome is a condition in which an abnormal electrical connection (also known as a bypass tract), exists between the atria and the ventricles of the heart. This abnormal connection allows electrical signals to bypass the AV node, and enter the ventricles directly, resulting in an abnormally fast heart rate.

The electrical abnormality in Wolff-Parkinson-White Syndrome may be identified on an electrocardiogram.

What are the symptoms?

Symptoms of Wolff-Parkinson-White syndrome are the result of the rapid heart rate. Symptoms most often occur for the first time when people are in their teens or twenties. 

Common symptoms include:

• Palpitations
• Giddiness
• Feeling faint
• Tiring easily during exercise
• Anxiety
• An episode of a very rapid heartbeat can occur suddenly and last for a few seconds to several hours. Episodes often happen during exercise. Sometimes these episodes may be triggered by the intake of alcohol or caffeine.

Over time, symptoms of WPW may disappear in as many as 25 percent of people.

Some people with Wolff-Parkinson-White Syndrome may experience a more serious forms of tachycardia which can be dangerous.

Risk Stratification:

Decision on the need and type of treatment is based on risk stratification of the individual. Risk stratification is performed to determine which individuals with WPW are at risk for Sudden Cardiac Death.

Symptoms in more-serious cases may include:

• Chest pain
• Chest tightness
• Shortness of breath
• Rarely, sudden death

Risk stratification is performed via programmed electrical stimulation (PES) in the cardiac electrophysiology laboratory. In this procedure, the atria are stimulated to try to induce a tachycardia.  If a tachycardia involving the accessory pathway can be triggered, the cardiologist can then assess how rapidly the accessory pathway is able to conduct. The faster it can conduct, the higher the likelihood the accessory pathway can conduct fast enough to trigger a lethal tachycardia.

Treatment of WPW

People with WPW who experience severe symptoms (eg. low blood pressure, lethargy with altered mental status) may require synchronized electrical cardioversion. However, in those who are relatively stable, pharmacologic treatment may be used.

The definitive treatment of WPW is a destruction of the abnormal electrical pathway by radiofrequency catheter ablation. This procedure is performed by cardiac electrophysiologists. Radiofrequency catheter ablation is not performed in all individuals with WPW because there are inherent risks involved in the procedure. When performed by an experienced electrophysiologist, radiofrequency ablation has a high success rate.

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Further Reading

The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.