What Is Wolff Parkinson White Syndrome?

You may have heard the name ‘Parkinson’ as it commonly refers to a neurological disorder called Parkinson’s disease. What you may not know is, in 1930, Dr James Parkinson also discovered a common heart condition along with his colleague Dr Louis Wolff and Dr Paul Dudley White.¹ This article will explore the answer to the question, “What is Wolff-Parkinson-White syndrome?”

Wolff-Parkinson-White syndrome is a relatively common heart condition that makes the heart beat abnormally fast or causes a sudden episode of tachycardia. 

In this article, we will cover the cause, signs and symptoms, management and treatment, diagnosis, and complications of Wolff-Parkinson-White syndrome (WPW syndrome).

Overview

Wolff-Parkinson-White syndrome is a heart condition with a shortcut or an extra pathway in the heart’s electrical circuit. This additional pathway causes the heart to beat faster than usual before returning to normal. This condition is present at birth. However, symptoms may not present until later in life. 

Causes of wolff parkinson white syndrome

For the heart to contract and expand, it requires electrical signals to travel through the heart. At rest, the heart contracts 60 to 100 times per minute. However, in individuals with WPW syndrome, the heart contracts more than 100 times per minute in episodes lasting from a few seconds to several hours.

The abnormal heart rate in WPW syndrome is caused by faulty electrical conduction through an extra pathway between the heart’s upper and lower chamber that bypasses the regular cardiac conduction system. This additional pathway creates a shortcut or ‘short circuit’ for the electrical signal to conduct around the heart, causing the heart to contract faster.² This results in the sudden onset of tachycardia (increased heart rate).

Signs and symptoms of wolff parkinson white syndrome

Individuals with an extra circuit in their heart can sometimes not have an abnormal heartbeat. This condition is referred to as the WPW pattern. Whereas, individuals diagnosed with WPW syndrome always show tachycardia or a fast heart rate of more than 100 beats per minute temporarily. 

WPW syndrome symptoms include:

• Palpitations
• Light-headed, dizzy or faint
• Shortness of breath
• Anxious
• Sweating 
• Chest pain or discomfort

These symptoms can vary among individuals. Symptoms can last just a few seconds in some cases but others may experience symptoms lasting hours or days. The same applies to the number of occurrences or onset of symptoms. However, the onset can be triggered by excessive exercise, stress, caffeine, and alcohol.

Management and treatment for wolff parkinson white syndrome

The treatment for WPW syndrome can be varied depending on individual symptoms. Some patients may not need treatment if the onset occurs rarely. Treatment is required if a person experiences WPW onset frequently or passes out. 

WPW treatment includes:

Radiofrequency ablation (RFA) 

This treatment method uses heat to destroy heart tissue and restore a regular heartbeat. This method is a first-line treatment for both symptomatic WPW syndrome patients and WPW syndrome asymptomatic patients with high-risk jobs, such as athletes and pilots, where there are high chances of constant high blood pressure.

Cardioversion  

Uses an electronic device to regulate and restore a regular heartbeat. It is done using a small electric shock to counter the heart’s electrical signal and thus prolong the heartbeat.

Antiarrhythmic drugs  

A medication that acts on the atrioventricular node (AV).³ AV function is to generate an electrical signal that passes through the heart and causes the upper heart chamber and lower chamber to contract. Therefore, antiarrhythmic drugs increase the conduction velocity (prolonging the electrical signal duration), causing the heart to contract slower.

These antiarrhythmic drugs include:

• Diltiazem
• Metoprolol
• Atenolol

Accessory pathway drug 

Is used as a drug agent to slow the conduction velocity (prolonged signalling) in the bypass of WPW syndrome heart’s extra pathway.

These drugs include:

• Quinidine
• Flecainide
• Amiodarone
• Dofetilide
• Sotalol

Open heart surgery 

Was a standard procedure before RFA was developed. However, nowadays, this treatment method has become rare and is only used when the individual is recovering from another heart condition and patients in whom RFA treatment repeatedly fails.

Diet  

Patients with structural heart disease, such as WPW syndrome, require a low-salt and low-cholesterol diet.

Diagnosis of wolff parkinson white syndrome

• During or after the onset of tachycardia. WPW pattern can be identified via electrocardiogram (ECG). This can be via an ECG machine or an ambulatory ECG (portable).

• An injection of adenosine can be injected through a vein to allow the extra circuit in the heart to be identified.

• Doctors may conduct exercise tests, for example on a treadmill, to observe the heart rate and the onset of WPW.

• An echocardiogram may be used to observe the heart structure and its abnormality.

Complications

It is possible for individuals with WPW syndrome also to have another heart condition referred to as atrial fibrillation. Atrial fibrillation is when the electrical impulse in the heart’s top 2 chambers fires tumultuously instead of steadily, causing the heart to quiver or twitch. It can be life-threatening if not treated.

FAQs

How can I prevent wolff parkinson white syndrome?

There is currently no cure for Wolff-Parkinson-White syndrome. However, the onset can be treated and sometimes be reduced by avoiding alcohol, caffeine, stress, and excessive exercise.

How common is wolff parkinson white syndrome?

Wolff-Parkinson-White syndrome occurs in 1-3 of every 1,000 people globally. It usually runs within families and is more prevalent in those assigned male compared to those assigned female at birth.

When should I see a doctor?

When you or someone experiences the symptoms below, medical attention should be sought immediately.

• If you have fainted and cannot be woken up
• If you have experienced tachycardia and other WPW symptoms, i.e. sweating, dizziness, or shortness of breath
• If you experience pain or significant discomfort in your chest, neck, jaw, arms, or back for more than 15 minutes
• If you experience tachycardia that lasts longer than 10 minutes

Suppose you have been diagnosed with WPW syndrome and experienced its onset. In that case, taking medication or performing relieving techniques given by your doctors is recommended. If the symptoms do not improve, a doctor should be sought.

Summary

In conclusion, Wolff-Parkinson-White syndrome is a relatively common heart condition with an extra pathway (shortcut) that allows the heart to contract faster. It is hereditary and currently has no cure. However, various treatment methods can improve quality of life for those suffering from WPW syndrome.