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What is Wolff-Parkinson-White Syndrome (WPW)? |
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THIS IS WHAT I HAVEWhat is Wolff-Parkinson-White Syndrome (WPW)?
Normally, the heartbeat begins at the sinoatrial (SA) node, located in your right atrium. When the SA node fires, electrical activity spreads through the right and left atria, causing them to contract. The impulses travel to the atrioventricular (AV) node, which is the bridge that allows the impulses to go from the atria to the ventricles. The impulse then travels through the walls of the ventricles, causing them to contract. The heart’s regular pattern of electrical impulses causes the heart to fill with blood and contract in a normal fashion.
Normal heart rhythm
Wolff-Parkinson White
WPW is a form of supraventricular tachycardia (fast heart rate originating above the ventricles).
When you have WPW, along with your normal conduction pathway, you have extra pathways called accessory pathways. They look like normal heart muscle, but they may:
* conduct impulses faster than normal
* conduct impulses in both directions
The impulses travel through the extra pathway (short cut) as well as the normal AV-HIS Purkinje system. The impulses can travel around the heart very quickly, in a circular pattern, causing the heart to beat unusually fast. This is called re-entry tachycardia.
Re-entry arrythmias occur in about 50 percent of people with WPW; some may have atrial fibrillation (a common irregular heart rhythm distinguished by disorganized, rapid, and irregular heart rhythm). The greatest concern for people with WPW is the possibility of having atrial fibrillation with a fast ventricular response that worsens to ventricular fibrillation, a life-threatening arrhythmia,.
History:
In 1930, Wolff, Parkinson and White described a distinct electrocardiograph (ECG) pattern in healthy young people with short bursts of tachycardia. In 1933, other doctors noted the reason for this irregular rhythm was a faster passage of impulses traveling through the ventricles. In 1944, doctors confirmed the presence of extra pathways.
What causes WPW?
Prevalence:
It is the most common type of ventricular preexcitation arrhythmia. (preexcitation: The impulses travel to the ventricle earlier than what you would expect them to if they traveled down the normal pathway through the AV node).
It can occur at any age and is one of the most common causes of fast arrhythmia in infants and children.
The highest incidence occurs between the ages of 30 and 40 years old.
WPW may be:
* random
* congenital (present at birth)
Random
Most of WPW occurs randomly in the general population, occurring in about 0.1 to 3.1 per 1,000 persons. In the general population, men have a higher incidence of WPW than women do, and there is a higher incidence of multiple accessory pathways in men.
Congenital
Some cases of WPW are inherited. Parents who have accessory pathways may pass them on to their children. One paper suggested the incidence of preexcitation in first-degree relatives could be as high as 5.5 per 1,000 persons. About 7 to 20 percent of patients with WPW also have congenital defects within the heart.
What are the symptoms of WPW?
Most people experience symptoms between the ages of 11 and 50 years old.
Symptoms of WPW may include one or more of the following:
* heart palpitations – a sudden pounding, fluttering or
* racing feeling in your chest
* dizziness – feeling lightheaded or faint
* shortness of breath (dyspnea)
* anxiety
* rarely, cardiac arrest (sudden death)
Some people have WPW without any symptoms at all.
How is WPW diagnosed?
WPW is diagnosed by reviewing the results of several tests:
* ECG (electrocardiogram)
* Holter monitor
* Exercise testing
* Electrophysiology testing
These tests help the doctor learn if you are have ECG findings of WPW and presence of accessory pathways.
Your doctor will also ask you several questions:
* Do you have symptoms?
* Do you have a history of atrial fibrillation?
* Do you have a history of fainting?
* Do you have a history of sudden cardiac death or does anyone in your family?
* Are you a competitive athlete?
The results of your diagnostic tests and the answers to these questions will help guide your therapy.
How is Wolff-Parkinson-White syndrome treated?
Treatment depends on the type of arrhythmias, the frequency and the associated symptoms.
* Observation
If you have no symptoms, you may not require treatment. Your doctor may choose to have regular follow-up without treatment.
* Medications
A variety of drugs are available to treat arrhythmias. Because everyone is different, it may take trials of several medications and doses to find the one that works best for you.
Check the drug search to find out more about your medications.
It is important to know:
o the names of your medications
o what they are for
o how often and at what times to take them
* Ablation
In people with WPW, whose heart rate can not be controlled with medications, ablation can improve symptoms and cure the abnormal arrhythmias. During ablation, high-frequency electrical energy is delivered through a catheter to "disconnect" the abnormal pathways.
How to find a doctor if you have WPW
Adult: Click here to find a Cleveland Clinic Heart Center Cardiologist who specializes in the diagnosis and treatment of patients with WPW
Pediatrics: Dr. Richard Sterba
Sources:
Click here to find related publications written by Heart Center physicians
Al-Khatib SM, Pritchet ELC. (1999) Clinical features of Wolff-Parkinson-White Syndrome, AM Heart J,138, 403-13.
Packer DL, AV Node-Dependent Tachycardias, In Topol E. (Ed.), Textbook of Cardiovascular Medicine (pp.1727-1756). Philadelphia: Lipincott-Raven.
AHA (1994) Abnormal Heart Rhythms: What Parents Should Know, Dallas, TX: AHA.
 iCelticprincessz · Sat Dec 09, 2006 @ 10:01pm · 0 Comments |
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