WPW

DEFINITION

• Wolff-Parkinson-White syndrome is a heart condition in which there is an extra electrical pathway (circuit) in the heart. The condition can lead to episodes of rapid heart rate

• Wolff-Parkinson-White is one of the most common causes of fast heart rate disorders in infants and children.

CAUSES

• Normally, electrical signals in the heart go through a pathway that helps the heart beat regularly. The wiring of the heart prevents extra beats from occurring and keeps the next beat from happening too soon.

• In people with Wolff-Parkinson-White syndrome, there is an extra, or accessory, pathway that may cause a very rapid heart rate. This is called supraventricular tachycardia.

SYMPTOMS

• How often the rapid heart rate occurs depends on the patient. Some people with Wolff-Parkinson-White syndrome may have just a few episodes of rapid heart rate. Others may have the rapid heart rate once or twice a week. Sometimes there are no symptoms, and the condition is detected when a heart tests are done for another reason.

A person with WPW syndrome may have: * Chest pain or chest tightness * Dizziness * Light-headedness * Fainting * Palpitations (a sensation of feeling your heart beat) * Shortness of breath

EXAMS AND TESTS

• An exam performed during a tachycardia episode will reveal a heart rate greater than 230 beats per minute and blood pressure that is normal or low. A normal heart rate is 60 - 100 beats per minute in adults, and under 150 beats per minute in neonates, infants, and small children.

• If the patient is currently not having tachycardia, the physical exam may be completely normal.

• A test called EPS may help identify the location of the extra electrical pathway.

Wolff-Parkinson-White syndrome may be revealed by the following tests: * ECG (electrocardiogram) may show an abnormality called a "delta" wave. * Continuous ambulatory monitoring (Holter monitor)

TREATMENT

• Medication may be used to control or prevent rapid heart beating. These include adenosine, antiarrhythmics, and amiodarone.

• If the heart rate does not return to normal with medication, doctors may use a type of therapy called electrical cardioversion (shock).

• The current preferred therapy for Wolff-Parkinson-White syndrome is catheter ablation. This procedure involves inserting a tube (catheter) into an artery through a small cut near the groin up to the heart area. When the tip reaches the heart, the small area that is causing the fast heart rate is destroyed using a special type of energy called radiofrequency.

• Open heart surgery may also provide a permanent cure for Wolff-Parkinson-White syndrome. However, surgery is usually done only if the patient must have surgery for other reasons.