Overview
Wolff-Parkinson-White (WPW) Syndrome is a condition wherein there is an extra electrical pathway between the atria and the ventricles of the heart. This can lead to a rapid heart rate called tachycardia.
Associated Anatomy of Wolff Parkinson White (WPW) Syndrome
Human Heart
Alternative Name of Wolff Parkinson White Syndrome
Ventricular preexcitation with arrhythmia
Wolff Parkinson White (WPW) Syndrome Causes
It may be important to know how the heart normally beats to better comprehend the reasons for WPW syndrome. It can be caused by:
Congenital diseases
WPW syndrome is a form of congenital heart abnormality (present from birth). Other congenital cardiac diseases, such as the Ebstein anomaly, can lead to WPW syndrome.
Hereditary
WPW syndrome is inherited in a small percentage of cases. A thicker heart muscle is linked to the hereditary or familial type. Hereditary WPW syndrome is a form of hypertrophic cardiomyopathy.
Wolff Parkinson White Syndrome Symptoms
Signs and symptoms of WPW syndrome can be different for infants and adults.
WPW Syndrome in Adults
- Tachycardia (rapid heart rate; >100 beats per minute)
- Arrhythmia (Heart rhythm problem)
- Atrial fibrillation (chaotic and fast heart rhythm)
- Heart palpitations
- Pain in chest
- Breathing problems
- Nausea and dizziness
- Fatigue
- Anxiety
WPW Syndrome in Infants
- Pallor: Faded and pale skin colouration
- Cyanosis: Lips and nails turning bluish grey
- Pale or faded skin colour (pallor)
- Irritability and restlessness
- Rapid breathing
- Loss of appetite.
Wolff Parkinson White Syndrome Diagnosis
Electrocardiogram (ECG or EKG): ECG is a rapid and painless test that measures the heart's electrical impulses. WPW syndrome is marked by the presence of extra electrical pathways while looking for patterns of heart signals.
Other tests include a Holter monitor, which records heart rate for a couple of days during routine life activities, event recorder to check for arrhythmias and electrophysiological study to differentiate between WPW pattern and syndrome.
Wolff Parkinson White Syndrome Treatment
Treatment of WPW syndrome depends upon the associated arrhythmia’s type and the presence of other structural heart disease.
Following treatment options are there to monitor and eliminate the extra pathway.
Medications
Medications are given to treat arrhythmias. Different types of arrhythmias require different drugs. Therefore, patients may have to go through a few trials of arrhythmia medications.
Catheter ablation
Ablation therapy is a non-surgical invasive procedure. A flexible, thin tube called a catheter is inserted through blood vessels. The insertion is done via the groyne; the catheter reaches the heart and creates minute scars in the heart by producing radiofrequency energy. The scarring permanently blocks the abnormal electrical signals and restores normal heartbeat.
Risk Factors of Wolff Parkinson White Syndrome
Risk factors include:
- Tachycardia: Sudden cardiac arrest in young adults and children
- Accessory pathways in the heart
- Presence of multiple accessory pathways
- R-R interval of <250 milliseconds: happens during forward conduction of nerves through accessory pathways during atrial fibrillation (rapid heart rate due to poor blood flow)
- Structural heart diseases such as hypertrophic cardiomyopathy, Ebstein anomaly.
Possible Complication of Wolff Parkinson White Syndrome
Complications arise if the disease is not treated on time. The following can occur:
- Heart failure
- Serious arrhythmias
- Atrial fibrillation
- Cardiac arrest
- Tachyarrhythmia
- Palpitations
- Dizziness or syncope
- Sudden cardiac death
- Complications of drug therapy (eg proarrhythmia, organ toxicity)
- Complications associated with invasive procedures and surgery
- Recurrence
Wolff Parkinson White Syndrome Preventions
Primary Prevention of Wolff Parkinson White Syndrome
WPW is a congenital disease, therefore, it cannot be prevented. But, complications can be prevented by being aware of the disease. Some lifestyle changes also help prevent complications:
- Avoid smoking.
- Keep cholesterol and blood pressure in check.
- Consume healthy food.
- Maintain a healthy weight.
- Manage stress and do regular workout.
Secondary Prevention of Wolff Parkinson White Syndrome
Following are the secondary preventions for WPW syndrome recurrence:
- Avoid using over-the-counter decongestants and diet pills as they contain stimulants.
- Avoid taking drugs like cocaine, etc. All these drugs make your heart beat faster.
- Always be in touch with your cardiologist. Learn to perform Valsalva manoeuvre.
Epidemiology of Wolff Parkinson White Syndrome
- Prevalence: 100-300 per 100000 individuals are affected globally.
- Age: Generally affects people at the age of 30 to 40 years of age. The men to women ratio is 2:1.
- Gender: prevalent more in men than in women.
- Not particular to any racial community
- Only 7% of affected individuals are above 60 years of age worldwide.
Expected Prognosis of Wolff Parkinson White Syndrome
Timely identification and appropriate treatment can lead to positive prognosis in case of WPW syndrome. It can be permanently cured through radiofrequency (RF) catheter ablation. Patients with no symptoms and only showing preexcitation on ECG tend to have a very good prognosis.
Natural Progression of Wolff Parkinson White Syndrome
WPW is not a fatal disease for most affected people. Timely and appropriate treatment can cure the condition. However, the biggest challenge is sudden cardiac arrest because of tachycardia.
Pathophysiology of Wolff Parkinson White Syndrome
In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's atria and ventricles causes a rapid heartbeat, called tachycardia.
Other Conditions & Treatments
- Acute Coronary Syndrome
- Aortic Stenosis
- Atrial Fibrillation
- Atrial Flutter
- Cardiomyopathy
- Carotid Artery Disease
- Complete Heart Block
- Coronary Artery Disease
- Coronary Heart Disease
- Deep Vein Thrombosis
- Gangrene
- Heart Attack
- Hypertensive Heart Disease
- Hypertrophic Cardiomyopathy
- Low Blood Pressure
- Myocardial Infarction
- Peripheral Artery Disease
- Peripheral Vascular Disease
- Prosthetic Valve Failure
- Rheumatic heart disease
- Supraventricular Tachycardia
- Thromboembolic disease
- Unstable Angina
- Valvular Heart Disease
- Varicose Veins
- Vascular Malformation
- Ventricular Fibrillation
- Ventricular Tachycardia