Wolff–Parkinson–White

Wolff–Parkinson–White syndrome (WPW) is a disorder due to a specific type of problem with the electrical system of the heart which has resulted in symptoms. About 40% of people with WPW do not have symptoms. WPW is characterized by the presence of an abnormal accessory electrical conduction pathway between the atria and the ventricles.

Signs and symptoms

Symptoms can be absent or include palpitations, dizziness, fainting, or, rarely, sudden cardiac death. The age at which symptoms start is variable ranging from infancy to late adulthood, with the average age being between 11 and 50 years old.

Causes

The cause of WPW is typically unknown. Rarely it is associated with certain genetic disorders such as Holt–Oram syndrome, Danon disease, and Pompe disease. It is due to an accessory pathway known as the Bundle of Kent. This pathway may be present from birth or occur following a heart attack.

Diagnosis

Diagnosis is typically by an electrocardiogram (ECG) in which a pattern known as a delta wave may be seen. Other conditions that can produce similar ECG findings include hypertrophic cardiomyopathy and Ebstein anomaly.

Treatment

Treatment may be with medications, radiofrequency ablation, or surgery. Medications may include beta blockers, calcium channel blockers, or digoxin. If these are not effective antiarrhythmic agents such as propafenone or flecainide may be used. The accessory pathway can often be permanently interrupted using radiofrequency ablation. This procedure is successful in more than 90% of cases. If the person is in cardiac arrest due to ventricular fibrillation immediate defibrillation is recommended.

Epidemiology

WPW affects between 0.1 and 3% of the population. Males are affected more often than females. The condition was first described in detail in 1930 by Louis Wolff, John Parkinson, and Paul Dudley White.

See also

• Cardiology
• Electrophysiology

References

Wolff–Parkinson–White Resources
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