Wolff-Parkinson-White (WPW) Syndrome

Wolff-Parkinson-White syndrome is a common cause of paroxysmal supraventricular tachycardia Paroxysmal Supraventricular Tachycardia (SVT, PSVT) Paroxysmal supraventricular tachycardia is a regular, fast (160 to 220 beats per minute) heart rate that begins and ends suddenly and originates in heart tissue other than that in the ventricles... read more . Very rarely, this syndrome results in a very fast, life-threatening heart rate during atrial fibrillation Atrial Fibrillation and Atrial Flutter Atrial fibrillation and atrial flutter are very fast electrical discharge patterns that make the atria (upper chambers of the heart) contract very rapidly, with some of the electrical impulses... read more .

When infants develop arrhythmias due to this syndrome, they may become short of breath or lethargic, stop eating well, or have rapid, visible pulsations of the chest. Heart failure may develop.

Typically, when teenagers or people in their early 20s have an arrhythmia due to this syndrome, they experience it as an episode of palpitations Palpitations Palpitations are the awareness of heartbeats. The sensation may feel like pounding, fluttering, racing, or skipping beats. Other symptoms—for example, chest discomfort or shortness of breath—may... read more that begins suddenly, often during exercise. The episode may last for only a few seconds or may persist for several hours. For most people, the very fast heart rate is uncomfortable and distressing. A few people faint Fainting Light-headedness (near syncope) is a sense that one is about to faint. Fainting (syncope) is a sudden, brief loss of consciousness during which the person falls to the ground or slumps in a... read more .

In older people, episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome tend to cause more symptoms, such as fainting, shortness of breath, and chest pain.

Because Wolff-Parkinson-White syndrome changes the pattern of electrical activation in the heart, it can be diagnosed using electrocardiography Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more (ECG), which records the electrical activity of the heart.

Episodes of paroxysmal supraventricular tachycardia Paroxysmal Supraventricular Tachycardia (SVT, PSVT) Paroxysmal supraventricular tachycardia is a regular, fast (160 to 220 beats per minute) heart rate that begins and ends suddenly and originates in heart tissue other than that in the ventricles... read more due to Wolff-Parkinson-White syndrome can often be stopped by one of several maneuvers that stimulate the vagus nerve and thus slow the heart rate. Maneuvers include

These maneuvers are most effective when they are used shortly after the arrhythmia starts.

When these maneuvers are ineffective, drugs such as verapamil, diltiazem, or adenosine are usually given intravenously to stop the arrhythmia. Antiarrhythmic drugs may then be continued indefinitely to prevent episodes of a fast heart rate (see table ).

In infants and children younger than 10 years, digoxin may be given to suppress episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome. However, adults with the syndrome should not take digoxin because it can facilitate conduction by the extra pathway and increase the risk that atrial fibrillation will degenerate into ventricular fibrillation. For this reason, digoxin is usually stopped before people with this syndrome reach puberty.

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