Recognizing Wolff–Parkinson–White Syndrome

Wolfe-Parkinson-White (WPW) syndrome is a congenital heart condition characterized by abnormal electrical pathways that can lead to potentially life-threatening heart rhythms. This article defines WPW as a heart condition in which an abnormal accessory electrical pathway allows impulses to bypass the atrioventricular node, increasing the risk of rapid and irregular heart rhythms. It also distinguishes between the WPW pattern, which refers only to ECG findings, and WPW syndrome, which occurs when those findings are associated with symptoms such as palpitations, dizziness, or fainting. 

Despite Wolff–Parkinson–White being a birth condition, it is usually not recognised until much later in life. Individuals affected by this condition may have an extra electrical pathway that causes episodes of rapid heartbeats, sometimes brief enough to go unnoticed. WPW can be detected on an electrocardiogram (ECG) by noting a short PR interval and a slurred initial portion of the QRS complex, known as a delta wave. Most individuals with this pattern never develop symptoms; however, for others, this rapid rhythm can trigger palpitations, dizziness, or fainting, and in rare cases, individuals with additional heart complications may experience life-threatening outcomes, including death.

When arrhythmias are frequent or severe, treatments range from medications to procedures such as catheter ablation. It is a minimally invasive procedure that eliminates the abnormal electrical pathway in the heart. During this procedure, catheters are inserted through a blood vessel–usually through the groin area–where they are guided to the heart and the accessory pathway is identified and destroyed, depending on the severity, by heat or cold, restoring normal electrical conduction.

Reference

Chhabra, L., Goyal, A., & Benham, M. D. (2023, August 7). Wolff parkinson white syndrome (WPW). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554437/

Authors:

• Saveena Sangha and Jay Patadia.