WPW Syndrome

What is WPW syndrome?

Wolff-Parkinson-White or WPW syndrome is a condition of arrhythmia caused by an abnormality in the heart’s electrical conduction system. Normally, the heart’s electrical activity follows a specific pathway. The heartbeat begins when an electrical signal is emitted from a region called the sinus node in the right atrium of the heart. This electrical signal spreads to the atria and causes contraction. After the atria contract, the electrical impulse passes slowly through a structure called the AV node, which is located between the atria and ventricles. From there, it spreads to the ventricles. In WPW syndrome, there is an additional conduction pathway separate from the AV node. As the electrical signal travels through the heart, it passes not only through the AV node but also through this abnormal pathway to the ventricle.

Mechanism of WPW syndrome
Mechanism of WPW syndrome

You can find detailed information about WPW syndrome in the video below.

Why does WPW syndrome cause palpitations?

People with WPW (Wolff Parkinson White) syndrome have an abnormal extra pathway in the heart. The electrical signal creates an electrical loop that uses the abnormal extra pathway and the normal pathway (AV node). Each cycle causes a heartbeat and palpitations begin. Palpitations that start in this way, continue for a while and then stop are called paroxysmal tachycardia.

Some people have an extra conduction pathway but do not experience any symptoms. This accessory pathway may need to be tested by electrophysiological study. Accessory pathways with poor conductivity cannot cause palpitations and may not pose a risk for the patient.

What are the symptoms of WPW syndrome?

People with WPW syndrome may experience palpitations, chest pain with palpitations, shortness of breath, dizziness, fainting. In rare cases, Wolf Parkinson-White syndrome can be life-threatening. This is because the rhythm disturbance in the atria, called atrial fibrillation, is transmitted to the ventricles via extra conduction and the heart rate increases significantly.

How is WPW Syndrome Diagnosed?

WPW syndrome is recognized by performing a test called an “electrocardiogram” or ECG. Sometimes a 24-hour ECG recording, called a holter, can also help with the diagnosis. The ECG can show where in the heart this abnormal pathway is located, and if your doctor is going to perform a moxibustion procedure, he or she can have an idea of where the abnormal location is before the procedure is started.

Treatment for WPW syndrome?

Treatment of WPW syndrome,

  • Stopping palpitations
  • It can be considered as treatments for the elimination of the disease.

How to stop palpitations? The patient can perform manoeuvres such as coughing and straining to stop palpitations. It may be effective in some patients. In the hospital, the heart rhythm can be normalised with various medications or sometimes with electroshock. This is called cardioversion.

How is the eliminate diseases? A procedure called “catheter ablation” is used to eliminate the disease. It can be done with cold energy (Cryo) or hot energy (Radiofrequency). What this procedure does is to find the abnormal pathway, apply heat or cold to it and render it non-functional. This procedure has a high chance of success. During the procedure, your doctor sends thin catheters through veins or arteries in the groin to the heart. With these catheters, the electrical signal of the heart is evaluated and the abnormal area is located. Once located, the abnormal area is burned or frozen with catheters whose metal tip can be heated or cooled. The loss of function of the abnormal pathway can be seen immediately on the ECG. This treatment can completely eliminate the disease. The possibility of recurrence is low.

Reference: WPW

Update: Feb 17, 2024

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Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

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