Wolff-Parkinson-White syndrome (patient information)
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Wolff-Parkinson-White syndrome |
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Where to find medical care for Wolff-Parkinson-White syndrome? |
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Wolff-Parkinson-White syndrome On the Web |
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Directions to Hospitals Treating Wolff-Parkinson-White syndrome |
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Risk calculators and risk factors for Wolff-Parkinson-White syndrome |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Kashish Goel, M.D.
Overview
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart's normal rhythm (arrhythmia). The condition can lead to episodes of tachycardia. Wolff-Parkinson-White syndrome is one of the most common causes of fast heart rate disorders in infants and children.
What are the symptoms of Wolff-Parkinson-White syndrome?
How often the rapid heart rate occurs depends on the patient. Some people with Wolff-Parkinson-White syndrome may have just a few episodes of rapid heart rate. Others may have the rapid heart rate once or twice a week. Sometimes there are no symptoms, and the condition is detected when a heart tests are done for another reason.
A person with WPW syndrome may have:
- Chest pain or chest tightness
- Dizziness
- Light-headedness
- Fainting
- Sensation of fluttering or pounding in the chest (palpitations)
- Shortness of breath
In rare cases, arrhythmias associated with Wolff-Parkinson-White syndrome can lead to cardiac arrest and sudden death. The most common arrhythmia associated with Wolff-Parkinson-White syndrome is called paroxysmal supraventricular tachycardia.
What causes Wolff-Parkinson-White syndrome?
Normally, electrical signals in the heart go through a pathway that helps the heart beat regularly. The wiring of the heart prevents extra beats from occurring and keeps the next beat from happening too soon. In people with Wolff-Parkinson-White syndrome, there is an extra, or accessory, pathway that may cause a very rapid heart rate. This is called supraventricular tachycardia.
Who is at highest risk?
Mutations in the PRKAG2 gene cause Wolff-Parkinson-White syndrome. Most cases of Wolff-Parkinson-White syndrome occur in people with no apparent family history of the condition. These cases are described as sporadic and are not inherited. Familial Wolff-Parkinson-White syndrome accounts for only a small percentage of all cases of this condition.
When to seek urgent medical care?
Call your health care provider if symptoms of Wolff-Parkinson-White develop, or if you have this disorder and symptoms get worse or do not improve with treatment.
Diagnosis
- An exam performed during a tachycardia episode will reveal a heart rate greater than 230 beats per minute and blood pressure that is normal or low. A normal heart rate is 60-100 beats per minute in adults, and under 150 beats per minute in neonates, infants, and small children.
- If the patient is currently not having tachycardia, the physical exam may be completely normal.
- A test called Electrophysiologic study may help identify the location of the extra electrical pathway.
- Wolff-Parkinson-White syndrome may be revealed by the following tests:
- ECG (electrocardiogram) may show an abnormality called a "delta" wave.
- Continuous ambulatory monitoring (Holter monitor).
Treatment options
- Medication may be used to control or prevent rapid heart beating. These include adenosine, antiarrhythmics, and amiodarone.
- If the heart rate does not return to normal with medication, doctors may use a type of therapy called electrical cardioversion.
- Therapy for Wolff-Parkinson-White syndrome also includes catheter ablation. This procedure involves inserting a tube (catheter) into an artery through a small cut near the groin up to the heart area. When the tip reaches the heart, the small area that is causing the fast heart rate is destroyed using a special type of energy called radiofrequency.
- Open heart surgery may also provide a permanent cure for Wolff-Parkinson-White syndrome. However, surgery is usually done only if the patient must have surgery for other reasons.
Medications to avoid
Patients diagnosed with wolff-Parkinson-White syndrome should avoid using the following medications:
- Eletriptan
- Frovatriptan
- Zolmitriptan
If you have been diagnosed with wolff-Parkinson-White syndrome, consult your physician before starting or stopping any of these medications.
Where to find medical care for Wolff-Parkinson-White syndrome?
Directions to Hospitals Treating Wolff-Parkinson-White syndrome
What to expect (Outlook/Prognosis)?
Catheter ablation cures this disorder in most patients. The success rate for the procedure ranges between 85 - 95%. Success rate will vary depending on location of accessory pathway and number of accessory pathways.
Possible complications
Complications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition.
- Complications of surgery
- Reduced blood pressure (caused by continous rapid heart rate)
- Heart failure
- Side effects of medications
- Ventricular fibrillation: It may rapidly lead to shock, and requires emergency treatment (cardioversion).