What is Wolff-Parkinson-White syndrome?
Wolff-Parkinson-White syndrome (WPW) is a type of abnormal heartbeat. If you have WPW, you may have episodes of tachycardia, when your heart beats very rapidly. WPW affects between 1 and 3 of every 1,000 people worldwide.
Normally, electrical signals going through your heart in an organized way control your heartbeat. This allows blood to pass from the upper chambers of your heart (the atria) to the lower chambers (the ventricles), and then travel throughout your body.
What causes Wolff-Parkinson-White syndrome?
Normally, a structure in your heart called the sinoatrial (SA) node regulates how electricity passes from the upper chambers of your heart to the lower chambers. The SA node keeps your heartbeat at about 60 to 100 beats a minute. When you have WPW, you are born with an extra pathway that allows electrical signals to bypass the sinoatrial node. This can result in a very rapid heart rate—200 beats per minute or more.
Who is at risk for Wolff-Parkinson-White syndrome?
WPW affects both men and women. In most cases, the cause of WPW isn’t known, but researchers have identified mutations in a gene that may be responsible. A small number of people may be at risk because they inherited this gene from a parent. WPW is a common cause of tachycardia in China. You may be at increased risk if you are of Chinese descent.
What are the symptoms of Wolff-Parkinson-White syndrome?
With WPW, you may not have any episodes of tachycardia for many years. Symptoms may also start and stop suddenly and occur at any age. Typical symptoms include:
- Shortness of breath
- A pounding in your chest
- Passing out
How is Wolff-Parkinson-White syndrome diagnosed?
If you have symptoms of tachycardia that come and go, your health care provider will do a test called an electrocardiogram, or ECG. This measures the electrical activity in your heart and your heart rate. If you are not having symptoms at the time of your ECG, results may look normal. Other tests may include:
- Conducting an ECG as you walk on a treadmill
- Wearing a type of recorder, called a Holter monitor, that takes an ECG over 24 hours
- Wearing a type of recorder, called an event recorder, that samples your heart rate over several days
- Electrophysiologic testing, a hospital procedure that involves threading catheters into your heart through a vein in your thigh
How is Wolff-Parkinson-White syndrome treated?
You may not need any treatment if you do not have symptoms, or if you have infrequent symptoms. Also, symptoms sometimes go away as people get older. If you do need treatment, there are a number of options:
- You may be able to stop an episode of tachycardia by massaging your neck, coughing, or bearing down like you are having a bowel movement. This is called a Valsalva maneuver.
- You may be able to take medication to stop or prevent tachycardia.
- If medication and the Valsalva maneuver do not work, you may need to go to the hospital for cardioversion. This procedure restores your heartbeat to a normal rhythm, by passing an electric current through your chest into your heart.
- If you are having frequent or uncontrolled episodes of tachycardia, you may have a surgical procedure called radiofrequency ablation. Low-voltage, high-frequency electrical energy interrupts the extra pathway in your heart. Your health care provider threads a catheter into your heart through a vein in your thigh. The treatment cures WPW about 95% of the time.
What are the complications of Wolff-Parkinson-White syndrome?
WPW is not a dangerous disease for most people. You can manage or correct the condition with treatment. The biggest risk is for sudden death from a heart attack, which tachycardia can cause. However, this is extremely rare. It occurs in less than one-half of 1% of cases.
How can I manage Wolff-Parkinson-White syndrome?
There is no way to prevent WPW, but you can prevent complications by learning as much as you can about the disease. Work closely with your cardiologist (health care provider who specializes in diseases of the heart) to find the best treatment. Ask him or her to teach you how to do a Valsalva maneuver.
Here are helpful lifestyle suggestions:
Work with your health care provider to keep conditions like high cholesterol and high blood pressure under control.
Eat a heart-healthy diet.
Maintain a healthy weight.
Get regular exercise.
Tell your health care provider right away if you have symptoms of WPW.
- Wolff-Parkinson-White syndrome is a type of abnormal heartbeat.
- In addition to tachycardia, a fast heartbeat, you may have shortness of breath, a pounding in your chest, or dizziness. You also may pass out.
- You may not need treatment, if your episodes of tachycardia are infrequent.
- If you need treatment, there are various options.
- Consult with your health care provider right away if you have symptoms of Wolff-Parkinson-White syndrome.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
- Fraser, Marianne, MSN, RN
- Sohrabi, Farrokh, MD