Wolff-Parkinson-White Syndrome

Overview

What is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White syndrome (WPW) is a heart condition that occurs in people born with a certain heart defect. This congenital condition (meaning, you were born with it) changes the usual pathway that electrical impulses, or signals, travel through your heart. If you have WPW syndrome, you have an extra signal pathway. When signals take this changed route, this puts your heart at risk for beating too fast.

Your heart beats too quickly if you have Wolff-Parkinson-White syndrome because an accessory pathway lets electrical signals through without the delay that happens in a typical heart.

If you have Wolff-Parkinson-White syndrome, a type of preexcitation syndrome, you have an extra signal pathway for electrical signals in your heart, making your heart beat too quickly.

How does Wolff-Parkinson-White syndrome affect my heart?

Wolff-Parkinson-White syndrome changes how electrical impulses move through your heart. In WPW syndrome, you have an extra (accessory) pathway in your heart.

Electrical impulses take the extra pathway instead of the usual route. When electrical impulses follow the extra pathway, they travel through the heart too quickly. This causes your heart to beat rapidly (a type of arrhythmia called supraventricular tachycardia).

What controls your heartbeat?

Your heartbeat is the rhythmic way your heart muscle contracts to pump blood. Your heart’s right upper chamber (right atrium) contains the sinoatrial (SA) node. This node sends electrical impulses that tell the upper chambers (both right and left atria) to contract.

Impulses then travel to the atrioventricular (AV) node and slow down, allowing the ventricles to fill with blood. The impulses then tell the ventricles to contract and pump blood out of the heart.

In a typical heart, electrical impulses follow this same pathway through the heart repeatedly. This cycle keeps the heart beating at a steady pace, between 60 and 100 times per minute.

Does Wolff-Parkinson-White syndrome have other names?

Wolff-Parkinson-White syndrome is also known as:

  • Auriculoventricular accessory pathway syndrome.
  • Preexcitation syndrome.
  • Ventricular familial preexcitation syndrome.
  • False bundle branch block syndrome.

Who does Wolff-Parkinson-White syndrome affect?

Anyone can get Wolff-Parkinson-White syndrome, and the condition may run in families. WPW is more common in people of Chinese descent. 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.

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 United States.

Symptoms and Causes

What causes Wolff-Parkinson-White syndrome?

Healthcare providers don’t always 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. They’ve identified some changes (mutations) in certain genes that may cause a specific type of WPW syndrome called familial Wolff-Parkinson-White syndrome.

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

Wolff-Parkinson-White syndrome symptoms vary. You might not have any symptoms at all. Or you may experience:

Diagnosis and Tests

How do healthcare providers diagnose Wolff-Parkinson-White syndrome?

Healthcare providers usually diagnose Wolff-Parkinson-White with EKG (electrocardiogram). Your healthcare provider may also notice changes to your heartbeat during a physical examination. Let your provider know if your heartbeat feels different or if you have other symptoms of Wolff-Parkinson-White syndrome.

What tests do healthcare providers use to diagnose Wolff-Parkinson-White syndrome?

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

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

Management and Treatment

How do healthcare providers treat Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White syndrome treatment varies. You might not need any treatment if you don’t have symptoms often. If you experience rapid heartbeat frequently with symptoms such as 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 there are 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.

Are there complications of Wolff-Parkinson-White syndrome?

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 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.
Care At Cleveland Clinic

Prevention

How can I prevent Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White syndrome is a condition you’re born with. There’s nothing you can do to prevent it.

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

Some people with Wolff-Parkinson-White syndrome may also have other heart conditions such as:

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

Outlook / Prognosis

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

You will work with your healthcare provider to manage any symptoms of Wolff-Parkinson-White syndrome. You’ll have regular appointments to make sure your symptoms are under control or haven’t gotten worse. Make sure to attend all your appointments and follow your provider’s instructions. Let your provider know right away if you experience new or worsening symptoms.

Is Wolff-Parkinson-White syndrome curable?

People who receive treatment for Wolff-Parkinson-White syndrome have typical lifespans. Radiofrequency ablation or surgery can cure WPW in many people. Your provider may recommend controlling WPW symptoms with medication.

Living With

What can’t I eat or drink if I have Wolff-Parkinson-White syndrome?

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

When will I feel better after treatment for Wolff-Parkinson-White syndrome?

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.

How do I take care of myself if I have Wolff-Parkinson-White syndrome?

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

When should I see my healthcare provider?

Let your healthcare provider know right away if you experience rapid heartbeat or other symptoms of Wolff-Parkinson-White syndrome. If you have an episode of rapid heartbeat that you can’t control at home, especially with other WPW symptoms, call your provider right away.

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.

What questions should I ask my healthcare provider about Wolff-Parkinson-White syndrome?

If you (or your child) have 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 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?
  • How can I live best with WPW?

A note from Cleveland Clinic

Wolff-Parkinson-White syndrome (WPW) is a congenital heart condition that causes electrical impulses to travel through your heart in ways that aren’t typical. These impulses cause episodes of rapid heartbeat. Healthcare providers often treat WPW with medication and catheter ablation.

Last reviewed by a Cleveland Clinic medical professional on 10/26/2022.

References

  • American Academy of Family Physicians. FamilyDoctor.org. Wolff Parkinson White syndrome. (https://familydoctor.org/condition/wolff-parkinson-white-syndrome/) Accessed 10/26/2022.
  • Genetic and Rare Diseases Information Center. Wolff-Parkinson-White syndrome. (https://rarediseases.info.nih.gov/diseases/7897/wolff-parkinson-white-syndrome) Accessed 10/26/2022.
  • National Heart, Lung, and Blood Institute. How the Heart Works. (https://www.nhlbi.nih.gov/health-topics/how-heart-works) Accessed 10/26/2022.
  • National Organization for Rare Disorders. Wolff Parkinson White Syndrome. (https://rarediseases.org/rare-diseases/wolff-parkinson-white-syndrome/) Accessed 10/26/2022.
  • Srivastav S, Jamil RT, Zeltser R. Valsalva Maneuver. (https://www.ncbi.nlm.nih.gov/books/NBK537248/) 2021 Jul 28. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jan-. Accessed 10/26/2022.

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