Wolff-Parkinson-White (WPW) Syndrome Overview and Treatment

Wolf Parkinson White syndrome is a relatively rare but, in certain cases, dangerous condition that can lead to a very fast heartbeat, and in some cases, Sudden Cardiac Death (SCD). WPW syndrome is an inherited condition that is often asymptomatic.

In a normal heartbeat, electrical impulses travel from the SA node in the right atrium and are transmitted through the AV node into the ventricles in a regular and rhythmic manner. During an episode of atrial flutter or atrial fibrillation the atria pump at a much faster rate. Normally, however, the AV node slows the electrical impulses to the ventricles, which beat at a slower speed than the atria but usually at a faster rate than normal rhythm. This protective mechanism of controlling electrical impulse propogation to the lower chambers is absent in patients with WPW. This means that their ventricles squeeze at the same rate as the atrium in atrial fibrillation or flutter, which causes the ventricles to no longer properly squeeze blood. This causes sudden death.

Even when there is not atrial fibrillation or atrial flutter, WPW often allows a short circuit to occur resulting in periods of very rapid beating involving both the AV node and the extra connection (called an accessory pathway). Disrupting the accessory pathway by heating it up permanently fixes this rhythm problem and eliminates the risk of sudden death and periodic rapid heart beats causeed by that extra connectionn.

Diagnosing WPW Syndrome

Even those who show no outward signs of heart disease can be diagnosed with WPW syndrome using a standard electrocardiogram or EKG.

Treatment for WPW

There are many stopgap measures to treat WPW syndrome, including medication. However the most effective treatment for this disorder involves the ablation or destruction of the offending accessory pathways. By eliminating the pathways that bypass the AV node, electrical impulses will run their normal course.

Prognosis

The prognosis for patients who are accurately diagnosed with WPW before a significant cardiac event occurs is very good. Treatment using catheter ablation is very successful, and, on average, leads to a complete resolution in 95% of patients. Recurrence rates are relatively low after a successful ablation. However, patients should receive regular check-ups to ensure the long-term success of the procedure and that no recurrent accessory pathway conduction develops.