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(A-Z listing includes diseases, conditions, tests and procedures)
 

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 one to three of every 1,000 people worldwide.

Electrical signals going through your heart in an organized way control your heartbeat. This allows blood to pass from the upper chambers (the atria) to the lower chambers (the ventricles), and then to travel throughout your body.

Normally, a structure in your heart called the atrioventricular node regulates how electricity passes from the upper chambers to the lower chambers. If you have WPW, you were born with an extra pathway, in parallel with the atrioventricular node, which allows electrical signals to race back and forth between the upper and lower chambers. This can result in a very rapid heart rate — 200 beats per minute or more.

Illustration showing a cross section of the heart and the electrical system
Click Image to Enlarge

Symptoms

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

  • dizziness

  • passing out

Who’s at Risk

WPW affects both men and women. In most cases, the cause of WPW isn’t known, but doctors 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, and you may be at increased risk if you are of Chinese descent.

Diagnosis

If you have symptoms of tachycardia that come and go, your doctor will do a test called an electrocardiogram, or ECG. An ECG 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

Follow the journey: Finding the right arrhythmia treatment

The victim of an unexpected ventricular fibrillation, James Cromwell was saved by the intervention of Johns Hopkins electrophysiologists. But the initial approach wasn’t enough to comfortably control his severe condition. So doctors tried something new: they tracked down the patch of heart cells causing the extra beats and destroyed them.

Treatment

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 several 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.

  • Medication may 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, a surgical procedure called radiofrequency ablation may be performed. Low-voltage, high-frequency electrical energy interrupts the extra pathway in your heart. Your doctor threads a catheter into your heart through a vein in your thigh. The treatment cures WPW about 95 percent of the time.

Complications

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, occurring in less than one-half of 1 percent of cases.

How to Manage or Live with WPW

There is no way to prevent WPW, but you can prevent complications by learning as much as you can about the disease and working closely with your cardiologist to find the best treatment. Ask your doctor to teach you how to do a Valsalva maneuver.

Here are helpful lifestyle suggestions:

  • Don’t smoke.

  • Work with your doctor to keep conditions such as high cholesterol and high blood pressure under control.

  • Eat a heart-healthy diet.

  • Maintain a healthy weight.

  • Exercise regularly.

  • Tell your doctor right away if you have symptoms of WPW.

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