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Definition

By Mayo Clinic Staff


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In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's upper
chambers (atria) and lower chambers (ventricles) causes a rapid heartbeat (tachycardia).

The extra electrical pathway is present at birth and fairly rare. WPW is detected in about 4 out of every
100,000 people. People of all ages, including infants, can experience the symptoms related to Wolff-
Parkinson-White syndrome. Most people with symptoms first experience them between the ages of 11
and 50.

The episodes of fast heartbeats usually aren't life-threatening, but serious heart problems can occur.
Treatment for Wolff-Parkinson-White syndrome can stop or prevent episodes of fast heartbeats. A
catheter-based procedure, known as ablation, can permanently correct the heart rhythm problems.

Symptoms
By Mayo Clinic Staff
Symptoms of Wolff-Parkinson-White syndrome are the result of a fast heart rate. They most often
appear for the first time in people in their teens or 20s. Common symptoms of WPW syndrome include:

Sensation of rapid, fluttering or pounding heartbeats (palpitations)
Dizziness
Lightheadedness
Fainting
Tiring easily during exercise
Anxiety
An episode of a very fast heartbeat can begin suddenly and last for a few seconds or several hours.
Episodes often happen during exercise. Caffeine or other stimulants and alcohol may be a trigger for
some people. Over time, symptoms of WPW may disappear in as many as 25 percent of people who
experience them.

Symptoms in more-serious cases

About 10 to 30 percent of people with Wolff-Parkinson-White syndrome occasionally experience a type
of irregular heartbeat known as atrial fibrillation. In these people WPW signs and symptoms may
include:

Chest pain
Chest tightness
Difficulty breathing
Rarely, sudden death
Symptoms in infants

Symptoms in infants with Wolff-Parkinson-White syndrome may include:

Shortness of breath
Lack of alertness or activity
Poor eating
Fast heartbeats visible on the chest
No symptoms

Most people who have an extra electrical pathway in the heart experience no fast heartbeat and no
symptoms. This condition, called Wolff-Parkinson-White pattern, is discovered only by chance when a
person is undergoing a heart exam for other reasons. Wolff-Parkinson-White pattern is harmless in
many people. But doctors may recommend further evaluation before children with WPW pattern
participate in high-intensity sports.

When to see a doctor

A number of conditions can cause irregular heartbeat (arrhythmia). It's important to get a prompt,
accurate diagnosis and appropriate care. See your doctor if you or your child experiences any symptoms
associated with Wolff-Parkinson-White syndrome.

Call 911 or your local emergency number if you experience any of the following symptoms for more
than a few minutes:

Rapid or irregular heartbeat
Difficulty breathing
Chest pain

Causes
By Mayo Clinic Staff
In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's upper
chambers (atria) and lower chambers (ventricles) causes a rapid heartbeat (tachycardia). This pathway
of Wolff-Parkinson-White syndrome is present at birth. An abnormal gene (gene mutation) is the cause
in a small percentage of people with the syndrome. WPW also is associated with some forms of
congenital heart disease, such as Ebstein's anomaly. Otherwise, little is known about why this extra
pathway develops.

Normal heart electrical system

Your heart is made up of four chambers two upper chambers (atria) and two lower chambers
(ventricles). The rhythm of your heart is normally controlled by the sinus node, a mass of tissue in the
right atrium. The sinus node produces electrical impulses that generate each heartbeat.

These electrical impulses travel across the atria, causing muscle contractions that pump blood into the
ventricles. The electrical impulses then arrive at a cluster of cells called the atrioventricular node (AV
node) usually the only pathway for signals to travel from the atria to the ventricles. The AV node
slows the electrical signal before sending it to the ventricles. This slight delay allows the ventricles to fill
with blood. When electrical impulses reach the ventricles, muscle contractions pump blood to the lungs
and the rest of the body.

Abnormal electrical system in WPW

In Wolff-Parkinson-White syndrome, an extra electrical pathway connects the atria and ventricles,
allowing electrical impulses to bypass the AV node. When the electrical impulses use this detour through
the heart, the ventricles are activated too early (pre-excitation).

The extra electrical pathway can cause two major types of rhythm disturbances:

Looped electrical impulses. In WPW, the heart's electrical impulses travel down either the normal or the
extra pathway and up the other one, creating a complete electrical loop of signals. This condition, called
AV reentrant tachycardia, sends impulses to the ventricles at a very rapid rate. As a result, the ventricles
pump very quickly, causing rapid heartbeat.
Disorganized electrical impulses. If electrical impulses don't begin correctly in the right atrium, they may
travel across the atria in a disorganized way, causing the atria to beat very quickly and out of step with
each other (atrial fibrillation). The disorganized signals and the extra pathway of WPW also can cause
the ventricles to beat faster. As a result, the ventricles don't have time to fill with blood and don't pump
enough blood to the body.


Wolff-Parkinson-White Syndrome (WPW)
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What is Wolff-Parkinson-White Syndrome (WPW)?
What causes WPW?
What are the symptoms?
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How is WPW treated?
How to find a doctor if you have WPW
What is Wolff-Parkinson-White Syndrome (WPW)?
Normally, the heartbeat begins at the sinoatrial (SA) node, located in your right atrium. When the SA node fires, electrical
activity spreads through the right and left atria, causing them to contract. The impulses travel to the atrioventricular (AV) node,
which is the bridge that allows the impulses to go from the atria to the ventricles. The impulse then travels through the walls of
the ventricles, causing them to contract. The hearts regular pattern of electrical impulses causes the heart to fill with blood and
contract in a normal fashion.
Normal Heart Rhythm

Wolff-Parkinson White (WPW)


WPW is an electrical abnormality in the heart that may be associated with supraventricular tachycardia (fast heart rate originating
above the ventricles).
When you have WPW, along with your normal conduction pathway, you have an extra pathway called an accessory pathway.
They are normal heart muscle, not specialized electric tissue, and they may:
Conduct impulses faster than normal
Conduct impulses in both directions
The impulses travel through the extra pathway (short cut) as well as the normal AV-HIS Purkinje system. The impulses can
travel around the heart very quickly, in a circular pattern, causing the heart to beat unusually fast. This is called re-entry
tachycardia.
Wolff-Parkinson-White Syndrome - WPW
Re-entry arrhythmias occur in about 50 percent of people with WPW; some patients may also have atrial fibrillation(a common
irregular heart rhythm distinguished by disorganized, rapid, and irregular heart rhythm). Although rare, the greatest concern for
people with WPW is the possibility of having atrial fibrillation with a fast ventricular response that worsens to ventricular
fibrillation, a life-threatening arrhythmia.
History
In 1930, Wolff, Parkinson and White described a distinct electrocardiograph (ECG) pattern in healthy young people with short
bursts of tachycardia. In 1933, other doctors noted the reason for this irregular rhythm was a faster passage of impulses traveling
through the ventricles. In 1944, doctors confirmed the presence of extra pathways.
What causes WPW?
Prevalence:
WPW is a congenital heart abnormality. It is the most common type of ventricular preexcitation (preexcitation: the impulses
travel to the ventricle earlier than what you would expect them to if they traveled down the normal pathway through the AV
node).
WPW occurs randomly in the general population, occurring in about 1 to 3 per 1,000 persons. In the general population, men
have a higher incidence of WPW than women do, and there is a higher incidence of multiple accessory pathways in men.