Wolff-Parkinson-White (WPW) syndrome

Overview

Wolff–Parkinson–White syndrome (WPW) is a cardiac condition that manifests in individuals who are born with a specific congenital heart defect. This condition changes the normal route that electrical impulses, or signals, take through the heart. Individuals with WPW syndrome possess an additional signal pathway in their hearts. When signals travel an unusual route, the heart is at risk of beating too fast. WPW syndrome is also known as preexcitation syndrome. 

In WPW syndrome, the heart has an extra or accessory route. Electrical impulses use the alternate path instead of the conventional one. When electrical impulses use the other path, they pass through the heart too quickly. This results in a rapid heartbeat (a type of abnormal rhythm known as supraventricular tachycardia). 

While the episodes of rapid heartbeats observed in individuals with WPW syndrome are typically not life–threatening, there is a possibility of serious cardiac complications. In rare cases, WPW syndrome can lead to sudden cardiac death, particularly among children and young adults. WPW syndrome treatment may include special actions, drugs, cardioversion, or a catheter operation.

Symptoms

Symptoms of Wolff–Parkinson–White syndrome differ. A heart rate of more than 100 beats per minute is the most common symptom of WPW syndrome. Tachycardia or a rapid heart rate can occur unexpectedly and linger for a few seconds or several hours. Episodes of rapid heartbeats in individuals with WPW syndrome can manifest during physical activity or even at rest. 

Additional signs and symptoms of WPW syndrome are associated with the accelerated heart rate and the underlying arrhythmia. Supraventricular tachycardia is the most prevalent arrhythmia associated with WPW syndrome. It is characterized by rapid, pounding heartbeats that begin and end abruptly. Atrial fibrillation, a fast and chaotic heart rhythm, is also among the symptoms of WPW syndrome.

Common signs and symptoms of WPW syndrome include:

• Heart palpitations that can last a few seconds or several hours 
• Chest discomfort
• Difficulty breathing issues
• Dyspnea, or shortness of breath 
• Feeling dizzy or lightheaded
• Fainting
• Fatigue
• Anxiety

Infants with WPW syndrome may specifically exhibit a variety of signs and symptoms such as pale or fading skin color, cyanosis, poor eating, quick breathing, or irritability. 

There are cases where individuals with an extra electrical pathway do not exhibit any noticeable signs or symptoms of a rapid heartbeat. This particular condition is referred to as Wolff–Parkinson–White (WPW) pattern, which is often incidentally detected during a heart examination or test.

If one experiences a rapid heartbeat or other signs of Wolff–Parkinson–White syndrome, contact a healthcare provider for proper diagnosis and treatment. A rapid heartbeat can be caused by a variety of factors. A quick heartbeat, or heart rate, isn’t always a cause for alarm. However, consultation is still highly recommended. 

If you experience any of the following symptoms persistently for several minutes, it is crucial to immediately contact your local emergency number:

• Sensation of a rapid or pounding heartbeat
• Difficulty breathing
• Chest pain

Causes

In a normal heart, electrical impulses follow the same pathway through the heart repeatedly. In WPW syndrome, an extra electrical route joins the upper and lower heart chambers, allowing heart signals to bypass the AV node. As a result, heart signals do not slow down. The signals get more stimulated, and the heart rate increases. The presence of the extra pathway can also lead to the retrograde conduction of heart signals, resulting in an uncoordinated heart rhythm. 

The cause why this happens is still unknown. WPW syndrome is thought to have a potential familial predisposition, suggesting the existence of a family history, while in other cases, the condition may arise without a known cause. WPW syndrome can occur with other types of congenital cardiac disease, such as Ebstein anomaly. 

Researchers have found some changes in specific genes that may induce a kind of WPW syndrome known as familial Wolff–Parkinson–White syndrome. Or some may have an inherited condition known as hypertrophic cardiomyopathy, characterized by thickened heart muscle that can be linked to WPW syndrome.