The extra electrical pathway of Wolff-Parkinson-White syndrome is congenital (present at birth). While people of all ages, including infants, can experience the effects of Wolff-Parkinson-White syndrome, episodes of a fast heartbeat often first appear when people are in their teens or early 20s.
In most cases, the episodes of fast heartbeats aren’t life-threatening, but very serious heart problems can occur. Treatments for Wolff-Parkinson-White syndrome may stop or prevent episodes of fast heartbeats, and surgery to shut down the extra electrical pathway can usually correct the heart rhythm problems.
Wolff-Parkinson-White syndrome symptoms are the result of a fast heart rate. Common signs and symptoms include:
- Sensation of rapid, fluttering or pounding heartbeats (palpitations)
- Dizziness
- Lightheadedness
- Fainting
- Easily tired during exercise
- Anxiety
Symptoms most often appear for the first time in people in their teens or 20s. An episode of a very fast heartbeat can begin suddenly and last for a few seconds or several hours. Episodes often happen during exercise.
If a person with Wolff-Parkinson-White syndrome also has underlying heart disease, a rapid heart rate can lead to other serious symptoms, including chest pain, chest tightness, difficulty breathing and/or sudden death.
Symptoms in infants with Wolff-Parkinson-White syndrome may include shortness of breath, not alert or active, poor eating and/or fast heartbeats visible on the chest.
A person may have an extra electrical pathway in the heart but experience no fast heartbeat and no symptoms. This condition, called Wolff-Parkinson-White pattern, is only discovered by chance when a person is undergoing a heart exam for other reasons.
The extra electrical pathway of Wolff-Parkinson-White syndrome is present at birth. An abnormal gene (gene mutation) is the cause of a small percentage of cases of the disorder. Otherwise, little is known about why this extra pathway develops.
In Wolff-Parkinson-White syndrome, an extra electrical pathway connects the atria and ventricles. This means that an electrical signal can bypass the AV node. When electrical impulses use this detour through the heart, the ventricles are activated too early — a condition known as preexcitation. The extra electrical pathway in the heart doesn’t necessarily cause a fast heartbeat. However, this condition makes it possible for other processes to increase the heartbeat, including Looped Electrical Impulses and Disorganized Electrical Impulses.
The treatments goals for Wolff-Parkinson-White syndrome are to slow a fast heart rate when it occurs and prevent future episodes. A fast heartbeat may correct itself, and you may be able to slow your heart rate using simple physical movements. However, you may need medication or other medical treatment to slow down your heartbeat. Ways to slow your heartbeat include:
- Vagal maneuvers: Your doctor will ask you to perform an action, called a vagal maneuver, during an episode of a fast heartbeat. Vagal maneuvers affect the vagus nerve, which helps regulate your heartbeat. The maneuvers include coughing, bearing down as if you are having a bowel movement, and putting an icepack on your face.
- Medications: If vagal maneuvers don’t stop the fast heartbeat, you may need an injection of an anti-arrhythmic medication, such as adenosine, to restore a normal heart rate. An injection of this drug is administered at a hospital. Your doctor may also prescribe a pill version of an anti-arrhythmic drug, such as flecainide (Tambocor) or propafenone (Rythmol), to take if you have an episode of a fast heartbeat that doesn’t respond to vagal maneuvers.
- Cardioversion: In this procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and restores a normal rhythm. It’s typically used when maneuvers and medications aren’t effective.
With the following treatments, it’s possible to correct or manage problems related to Wolff-Parkinson-White syndrome in the majority of cases.
- Radiofrequency catheter ablation: This procedure is the most common treatment for Wolff-Parkinson-White syndrome. In this procedure, catheters are threaded through the blood vessels to your heart. Electrodes at the catheter tips are heated to damage (ablate) the extra electrical pathway and prevent it from sending electrical signals. This procedure is highly effective, and complications — which can include heart injury or infection — are uncommon.
- Medications: Anti-arrhythmic medications may prevent a fast heart rate when taken regularly. Medications are usually given to people who can’t undergo radiofrequency catheter ablation for some reason or don’t want to do the procedure.
- Surgery: The success rate for surgical destruction (ablation) of the extra pathway using open-heart surgery is almost 100 percent. However, because radiofrequency catheter ablation is almost as effective and less invasive, surgery for Wolff-Parkinson-White syndrome is now rare. It’s typically reserved for people who are having heart surgery for other reasons.
If you have the Wolff-Parkinson-White pathway but don’t have any symptoms, you probably won’t need treatment. In some people without symptoms, the extra pathway may spontaneously disappear over time.
Your doctor may be able to evaluate your risk of having episodes of a fast heartbeat based on findings from an ECG or electrophysiological testing. If he or she determines that you may be at risk of an event, your doctor may suggest radiofrequency catheter ablation.
Source: MayoClinic.com
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