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Wolff Parkinson White Syndrome (WPW)

Wolff-Parkinson-White syndrome, is a heart condition that may cause rapid heartbeats or arrhythmias. In people with WPW, an extra electrical pathway or nerve can conduct electrical impulses from the upper to the lower chambers of the heart. This extra pathway can be completely asymptomatic but can also cause the heart to beat too quickly, which can lead to palpitations and even rarely cause sudden death.
Fig 78 wpw
Wolff Parkinson White Syndrome is usually diagnosed through an electrocardiogram (ECG) but may need other tests such as Holter monitor, Stress test, echocardiogram, or an EP study.

Wolff Parkinson White Syndrome can cause a number of problems related to the heart's electrical activity, including:

Fig 7 SVT

Supraventricular tachycardia (SVT)

In people with WPW, the extra electrical pathway can become part of an electrical circuit causing rapid heartbeats, which may lead to symptoms such as palpitations, shortness of breath, chest pain, and dizziness.
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Fig 81 AF

Atrial fibrillation (AF)

WPW can increase the risk of developing atrial fibrillation in young patients. By eliminating the extra pathway, the risk of AF can be reduced in these patients.
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Fig 31 defib

Sudden Cardiac Arrest

Although very rare, WPW can also increase the risk of sudden cardiac arrest, which is a sudden loss of heart function that can be fatal if not treated immediately.
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WPW should be assessed carefully to decide if treatment for it is required. The assessment is centred around evaluating the risk of sudden death in these patients as well as the ability of this pathway to cause SVT. Often, an EP study is required to fully assess the pathway. If the pathway is deemed to be potentially dangerous or it can cause SVT, then treatment would be recommended.
Fig 8 WPW

The treatment of Wolff Parkinson White Syndrome depends on many factors but may include:

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Observation

When the pathway doesn’t cause symptoms and is considered to be low risk after careful assessment. The electrophysiologist may recommend observation without any treatment.

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Medications

If episodes of tachycardia are present and the patient is not suitable for ablation, antiarrhythmic drugs may be prescribed to control the heart rhythm.

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EP study and Ablation

Catheter ablation is a minimally invasive procedure that involves inserting a thin catheter through a blood vessel to the heart. The catheter is used to deliver radiofrequency energy to the extra electrical pathway, permanently eliminating the abnormal electrical connection. Catheter ablation has a very high success rate (>95%) in completely curing the problem with only minimal risks during the procedure.

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Surgery

In rare cases where medications and catheter ablation are not effective, open heart surgical intervention may be required to remove the extra electrical pathway.

If you have been diagnosed with Wolff Parkinson White Syndrome, it is important to see an electrophysiologist to determine the best course of action in terms of investigations and treatment.

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