What is it?
Wolff-Parkinson-White Syndrome (WPW) is a heart condition that occurs in approximately 1 out of 500 people. It is caused by an extra electrical "bypass tract" or shortcut that allows the electrical signal for the heart to beat to take a short cut from the upper chambers (atria) to the lower chambers (ventricles). The bypass tract causes a very specific finding on the electrocardiogram called "pre-excitation" or "delta waves".
Many people with WPW have episodes of rapid heart rates (supraventricular tachycardia or SVT), although some people never have this problem. In the latter case, the condition is often discovered accidentally when a physician is reviewing an electrocardiogram requested for some other purpose.
Regardless of whether a patient has SVT, however, there is also a risk of more dangerous heart rhythm problems beginning later in life. WPW can sometimes go away on its own over time, although this probably rarely happens after 3-4 years of age.
How is it treated?
In patients with SVT, this arrhythmia can often be treated with simple maneuvers or in some cases with medications (see SVT). If SVT is very difficult to manage, it is possible to eliminate WPW with a procedure called catheter-directed radio-frequency ablation (RFA). In this procedure a flexible tube called a catheter is guided to the bypass tract, then that tissue is destroyed with radiofrequency energy. In children over 4-5 years of age, in whom it is not likely that the bypass tract will go away over time, it is often considered prudent to perform catheter-directed radio-frequency ablation to eliminate the lifetime risk of other dangerous heart rhythm problems even if the patient does not have SVT. The decision whether to proceed with RFA is usually made in consultation with a Cardiac Electrophysiologist, a medical specialist who is expert in heart rhythm problems.
Wolff-Parkinson-White syndrome was named for Dr. Louis Wolff, Sir John Parkinson and Dr. Paul Dudley White, all at Massachusetts General Hospital in Boston at the time. The bicycle pathway running along the Charles River was named after Dr. White, who habitually traveled it on his way to the hospital from his home in Belmont, MA.
American Heart Association
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