Wolff-Parkinson-White Syndrome

What is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White syndrome (WPW) is a heart condition that occurs in people born with an extra electrical pathway for heartbeat signals. When electrical impulses or signals take this extra route instead of the usual one, they travel through your heart too quickly. This causes your heart to beat rapidly, a type of abnormal heart rhythm that healthcare providers call supraventricular tachycardia (SVT).

A heart that beats too fast doesn’t allow enough time for blood to fill its chambers before the next heartbeat. That means your heart can’t send as much blood to your body as it should.

How common is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White syndrome is rare. The condition happens in about 1 to 3 in 1,000 people in the world. Anyone can get Wolff-Parkinson-White syndrome, and the condition may run in families. WPW is more common in people of Chinese descent.

What are the symptoms?

Wolff-Parkinson-White syndrome symptoms vary. Most people don’t have any symptoms. But some people feel symptoms daily for a few seconds to a few hours. Others may feel them several times a year.

You may experience:

• Anxiety.
• Chest pain.
• Dizziness.
• Fainting.
• Fatigue.
• Heart palpitations that last for just a few seconds or a few hours.
• Shortness of breath (dyspnea).

Each year, about 1% to 2% of people with Wolff-Parkinson-White syndrome have an abnormal heart rhythm (arrhythmia).

What causes Wolff-Parkinson-White syndrome?

Healthcare providers usually don’t know the cause of Wolff-Parkinson-White syndrome. There may be a history of WPW syndrome in your family, or you may develop the condition due to an unknown cause.

Is Wolff-Parkinson-White syndrome hereditary?

Researchers aren’t sure whether parents pass Wolff-Parkinson-White syndrome to their children. Most people with WPW don’t have parents who have the disease, but you can inherit some genes that lead to WPW syndrome. These inherited cases are called familial Wolff-Parkinson-White syndrome.

What are the complications of Wolff-Parkinson-White syndrome?

People can injure themselves when they faint. Some people may experience low blood pressure during episodes of rapid heartbeat. A rare complication of Wolff-Parkinson-White syndrome is sudden cardiac death.

If you have any symptoms of Wolff-Parkinson-White syndrome, see your provider. Getting timely care for this condition can help avoid complications.

How is Wolff-Parkinson-White syndrome diagnosed?

Healthcare providers usually diagnose Wolff-Parkinson-White with an EKG (electrocardiogram). Your provider may also notice changes to your heartbeat during a physical examination. If your symptoms occur with exercise, they may recommend an exercise stress test. Let your provider know if your heartbeat feels different or if you have other symptoms of Wolff-Parkinson-White syndrome.

What tests will be done to diagnose Wolff-Parkinson-White syndrome?

Your healthcare provider may recommend certain tests to check your heartbeat, including:

• Electrocardiogram (EKG).
• Electrophysiology study.
• Holter monitor.
• Long-term ambulatory monitoring.

These tests give your healthcare provider information about your heart rate, rhythm and the presence of any signal conduction issues. Your provider can see visible heartbeat differences in a Wolff-Parkinson-White EKG compared to a normal EKG.

When is Wolff-Parkinson-White syndrome diagnosed?

Healthcare providers sometimes diagnose WPW syndrome in infants. But a diagnosis is more likely in your teens or early 20s, when symptoms become more noticeable.

Is Wolff-Parkinson-White syndrome associated with any other conditions?

Some people with Wolff-Parkinson-White syndrome may also have other heart conditions, like:

• Atrial fibrillation.
• Ebstein anomaly.
• Ventricular fibrillation (v-fib).

If you have multiple heart conditions, your provider will discuss with you how to manage your heart care.

How is Wolff-Parkinson-White syndrome treated?

Wolff-Parkinson-White syndrome treatment varies. You might not need any treatment if you don’t have symptoms often. And your symptoms may lessen and go away with time.

If you experience rapid heartbeat frequently with symptoms like dizziness or passing out, your healthcare provider may recommend:

• Radiofrequency ablation — a type of catheter ablation — uses energy to destroy a small amount of heart tissue and restore a regular heartbeat.
• Cardioversion helps stop an abnormal heartbeat if you have abnormal rhythms such as SVT and restores regular heart rhythm.
• Medication (chemical cardioversion) brings your rapid heartbeat under control or keeps your heartbeat regular over time.

Will I need surgery for Wolff-Parkinson-White syndrome?

Most people won’t need Wolff-Parkinson-White syndrome surgery. But in some cases, healthcare providers may use open heart surgery to block your heart’s extra pathway. Usually, providers use open heart surgery to treat WPW if they’re also repairing another heart condition.

How can I manage symptoms of Wolff-Parkinson-White syndrome at home?

If you experience rapid heartbeat at home, your healthcare provider may recommend that you:

• Breathe forcefully, as if you’re blowing up a balloon (Valsalva maneuver).
• Cough.
• Massage your neck.

Complications/side effects of the treatment

Any medication can have side effects.

While radiofrequency ablation is a safe and effective procedure, people who have catheter ablation can get:

1. Blood clots.
2. Infection.
3. Stroke.
4. Bleeding.

Complications from cardioversion are rare, too. Some people can get blood clots, injury to their skin from the procedure or a worsening arrhythmia.

How soon after treatment will I feel better?

At-home remedies like the Valsalva maneuver or coughing may slow your rapid heartbeat right away. Talk to your healthcare provider about what to expect if you’re taking medications for WPW.

Your provider can tell you when symptoms should improve after ablation or surgery for WPW. They can also tell you what to expect during recovery and when you can return to daily activities.

Can Wolff-Parkinson-White syndrome be prevented?

No. Wolff-Parkinson-White syndrome is a condition you’re born with. There’s nothing you can do to prevent it.

What can I expect if I have Wolff-Parkinson-White syndrome?

You can expect to work with your healthcare provider to manage any symptoms of Wolff-Parkinson-White syndrome. You’ll have regular appointments to make sure your symptoms aren’t getting worse. Make sure to go to all your appointments and follow your provider’s instructions. Let your provider know right away if you have new or worsening symptoms.

Outlook for Wolff-Parkinson-White syndrome

People who receive treatment for Wolff-Parkinson-White syndrome have a typical life expectancy. Radiofrequency ablation or surgery can cure WPW in many people.

Usually, people without symptoms have a low risk of having a cardiac arrest. People who have symptoms of tachycardia (fast heart rate) are more likely to have a cardiac arrest. But sudden cardiac death is rare in people with WPW.

How do I take care of myself?

See your healthcare provider for regular care. Always follow your provider’s instructions. Take care of your health in these ways:

• Eat healthy foods.
• Manage your blood pressure.
• Don’t use tobacco products.
• Avoid stimulants.
• Maintain a weight that’s healthy for you.

What can’t I eat/drink with Wolff-Parkinson-White syndrome?

Some substances might make your heart beat faster. Ask your provider if you should avoid:

• Alcohol.
• Caffeine.
• Stimulants like amphetamines or nicotine.

Can I exercise if I have Wolff-Parkinson-White syndrome?

Staying physically active is good for your body and mind. Ask your healthcare provider what you should know about Wolff-Parkinson-White syndrome and exercise. Talk to your provider about any specific risks you need to be aware of and whether you need to restrict any activities.

When should I see my healthcare provider?

If you have an episode of rapid heartbeat that you can’t manage at home, especially with other Wolff-Parkinson-White syndrome symptoms like lightheadedness, dizziness, chest pain or fainting, call your provider right away.

When should I go to the ER?

Get emergency help for a person who:

1. Has chest pain for longer than 15 minutes.
2. Has shortness of breath or upset stomach along with chest pain.
3. Passes out and doesn’t wake up.
4. Has a heartbeat that’s still abnormal after a few minutes.

What questions should I ask my doctor?

If you or your child has WPW, ask your provider:

• Is it safe to take medication for WPW with my other medicines?
• If I have WPW, will my children have it, too?
• How do I know if a rapid heartbeat is an emergency?
• Will my child be safe if they have a rapid heartbeat episode at school?
• Is it safe to play sports with Wolff-Parkinson-White syndrome?
• Should I have an invasive procedure like an ablation?

A note from Cleveland Clinic

Most parents don’t expect their child to have a heart problem. It can be scary when your child has a rapid heartbeat from Wolff-Parkinson-White syndrome. But treatments for this condition help — and even cure — many people. Ask your provider to show you how to ease symptoms yourself and what long-term solutions are best for you or your child.