Wolff-Parkinson-White Syndrome (WPW)
An extra electrical pathway causing fast heartbeats
Quick Facts
- Type: Heart rhythm disorder
- Cause: Extra electrical pathway present at birth
- Main symptom: Episodes of rapid heartbeat
- Possible cure: Catheter ablation
Overview
Wolff-Parkinson-White (WPW) syndrome is a heart rhythm condition that people are born with. Normally, electrical signals travel through the heart along one controlled route that sets a steady heartbeat. In WPW, there is an extra electrical pathway between the upper and lower chambers of the heart.
This extra connection can create a short circuit that lets signals loop quickly, triggering sudden episodes of a very fast heartbeat (tachycardia). Many people with the WPW electrical pattern never have problems, while others have episodes that can be uncomfortable or, rarely, dangerous. The good news is that WPW can often be cured with a procedure that removes the extra pathway.
WPW is sometimes discovered by chance when a heart tracing is done for another reason and shows the characteristic pattern. In other people, the first sign is a sudden episode of a racing heartbeat. Either way, a heart specialist can assess how the extra pathway behaves and advise on the best approach.
Symptoms
Symptoms usually come in episodes and can include:
- A sudden racing or pounding heartbeat (palpitations)
- Dizziness or lightheadedness
- Shortness of breath
- Chest discomfort or fluttering
- Anxiety or a feeling that something is wrong
- Fainting (less common)
Some people have no symptoms and learn they have the WPW pattern from a routine heart tracing. Fainting, chest pain, or a very fast heartbeat that does not stop needs emergency care.
Causes
WPW is caused by an extra electrical pathway that forms before birth, called an accessory pathway. Instead of all signals passing through the heart's normal junction, some travel along this extra route, which can set up a fast, looping rhythm.
In most people the reason the extra pathway forms is unknown. It is usually present from birth even if symptoms do not appear until later in life. In a small number of cases, WPW runs in families or is linked to certain inherited heart conditions.
Risk Factors
- Being born with the extra pathway (the underlying cause)
- A family history of WPW or other heart rhythm disorders
- Certain inherited heart muscle conditions
WPW is often found in otherwise healthy young people, including children and teenagers.
Diagnosis
Doctors diagnose WPW mainly through heart rhythm testing:
- Electrocardiogram (ECG): Often shows a characteristic pattern caused by the extra pathway, even between episodes.
- Holter or event monitor: A portable recorder that captures heart rhythm over time to catch episodes.
- Electrophysiology study: A specialized test that maps the heart's electrical pathways and locates the extra connection.
Treatment
Treatment depends on whether you have symptoms and how risky the episodes are.
- Catheter ablation: A procedure that uses a thin tube to find and destroy the extra pathway. It often cures WPW and is the preferred treatment for many people with symptoms.
- Vagal maneuvers: Techniques such as bearing down can sometimes stop an episode.
- Medicines: Drugs to slow the heart rate or prevent episodes in some people.
- Emergency treatment: Hospital care to restore a normal rhythm during a severe episode.
People without symptoms may simply be monitored, though some, such as athletes, may be assessed further to gauge risk.
For people who choose catheter ablation, the procedure is usually done in a specialized lab and has a high success rate, often allowing a person to stop ongoing medication. Your heart team will explain the benefits and small risks so you can decide on the best option for your situation.
Prevention
The extra pathway cannot be prevented because it is present from birth, but episodes and complications can be reduced:
- Learn and use vagal maneuvers if advised by your doctor
- Take prescribed medicines as directed
- Limit known triggers such as excessive caffeine or stimulants if they set off episodes
- Consider catheter ablation, which can permanently remove the pathway
- Attend follow-up care and report new or worsening symptoms
When to See a Doctor
See a doctor if you have episodes of a racing heartbeat, dizziness, or fluttering in the chest. Call emergency services right away if you have:
- A very fast heartbeat that does not stop
- Fainting or near-fainting
- Chest pain or severe shortness of breath
- A fast heartbeat with confusion or collapse
Frequently Asked Questions
Is Wolff-Parkinson-White syndrome dangerous?
For most people it is not dangerous, but it can cause uncomfortable episodes of fast heartbeat. In rare cases, especially if a fast rhythm combines with atrial fibrillation, it can be serious, which is why evaluation is important.
Can WPW be cured?
Yes. A procedure called catheter ablation can find and destroy the extra electrical pathway, often curing WPW permanently. It is a common and effective treatment for people with symptoms.
What triggers a WPW episode?
Episodes can start without warning, but exercise, stress, caffeine, or stimulants may trigger them in some people. The underlying cause is always the extra pathway present from birth.
How do I stop a WPW racing heartbeat?
Your doctor may teach you vagal maneuvers, such as bearing down or other techniques, to stop an episode. If the fast heartbeat does not stop, causes fainting, or comes with chest pain, seek emergency care.
Can people with WPW exercise?
Many can, but because exercise can trigger episodes, anyone with WPW, especially competitive athletes, should be evaluated by a heart specialist before deciding what activity is safe.
References
- American Heart Association. Wolff-Parkinson-White (WPW) Syndrome.
- Mayo Clinic. Wolff-Parkinson-White (WPW) syndrome.
- MedlinePlus, U.S. National Library of Medicine. Wolff-Parkinson-White syndrome.
- National Heart, Lung, and Blood Institute (NHLBI). Arrhythmia.