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Patient education: Wolff-Parkinson-White syndrome (The Basics)

Patient education: Wolff-Parkinson-White syndrome (The Basics)

What is Wolff-Parkinson-White syndrome? — Wolff-Parkinson-White (WPW) syndrome is a condition that can cause fast heartbeats that in turn cause episodes of dizziness or fainting.

People with WPW syndrome can have episodes when their heart beats much faster than normal. This can cause symptoms. The fast heartbeat can come and go suddenly. Sometimes, a fast heartbeat goes back to normal on its own. Other times, treatment is needed.

How do normal heartbeats happen? — A normal heartbeat happens when an electrical signal starts in one spot near the top of the heart. This electrical signal follows a path to spread across the heart. As it spreads, the signal causes the heart muscle to squeeze. Each time the heart squeezes, blood is sent all over the body. Normally, the heart beats in a regular way 60 to 100 times a minute.

People can have abnormal heartbeats if:

The electrical signal does not start in the right place

The electrical signal does not follow the right path as it spreads across the heart

Why is the heartbeat abnormal in WPW syndrome? — The heartbeat can be abnormal in WPW syndrome, because people with WPW syndrome have an abnormal extra path in the heart. When the electrical signal follows the abnormal extra path, the heart can beat at a rate that is much faster than normal.

Some people have an abnormal extra path in their heart, but they do not have a fast heartbeat. These people do not have any symptoms and do not have WPW syndrome. Instead, they have a "WPW pattern." These people usually do not need treatment.

What are the symptoms of WPW syndrome? — People with WPW syndrome can have symptoms that include:

Feeling their heart beating too fast

Feeling dizzy or light-headed

Fainting

Most people with WPW syndrome do not have any other heart problems, but some do. People with WPW syndrome who have other heart problems can have more serious symptoms. These include:

Chest pain

Trouble breathing

WPW syndrome can be life-threatening, because it can cause sudden death. But this is rare.

Is there a test for WPW syndrome? — Yes. Doctors can diagnose WPW syndrome by doing a test called an "electrocardiogram" (also called an "ECG") (figure 1). An ECG measures the electrical activity in the heart. It can show if a person has an abnormal heart rhythm or rate.

Sometimes, a doctor will do another procedure to figure out where the extra path is and if it needs to be treated.

How is WPW syndrome treated? — WPW syndrome is treated in different ways. Some treatments can stop episodes of fast heartbeats. Other treatments can prevent episodes of fast heartbeats from happening in the future.

What treatments can stop a fast heartbeat? — Treatments that can control a fast heartbeat include:

Actions – Actions that people can do themselves include:

Coughing or "bearing down" – Bearing down is when a person tightens their belly as if they are trying to have a bowel movement.

Pressing on and massaging the main artery on the side of the neck

Medicines

A procedure called "cardioversion" – This involves applying an electrical current to the heart to fix its rhythm.

What treatments can prevent future episodes of fast heartbeats? — Treatments that can prevent future episodes of fast heartbeats include:

A procedure called "radiofrequency catheter ablation" – This procedure can stop the abnormal path from spreading the electrical signal. During the procedure, a doctor puts thin wires into the blood vessels in the groin (inner thigh) or another part of the body. They thread the wires up through the blood vessels and into the heart. Then they use the wires to disconnect the abnormal path.

Medicines – Some people need to take medicines every day.

Surgery – A doctor can do surgery to disconnect the abnormal path in the heart. But radiofrequency catheter ablation is done far more often than surgery.

More on this topic

Patient education: Catheter ablation for the heart (The Basics)
Patient education: Implantable cardioverter-defibrillators (The Basics)
Patient education: Atrial fibrillation (The Basics)
Patient education: Pacemakers (The Basics)
Patient education: ECG and stress test (The Basics)

Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics)
Patient education: Catheter ablation for abnormal heartbeats (Beyond the Basics)
Patient education: Cardioversion (Beyond the Basics)
Patient education: Implantable cardioverter-defibrillators (Beyond the Basics)
Patient education: Atrial fibrillation (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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