Wolff-Parkinson-White Syndrome

In a normal heart, an electrical impulse from the sinoatrial node signals the upper chambers of the heart, the atria, to contract pumping blood into the lower chambers, the ventricles. When the ventricles are full of blood, electrical signals from the sinoatrial node travel along a pathway of cells to the ventricles, causing them to contract.

When a person is born with an extra electrical connection between the atria and the ventricles, the disorder is called Wolff-Parkinson-White syndrome. This extra electrical pathway makes it more likely that a person will develop rapid or irregular heartbeats, or arrhythmias. Usually these arrhythmias develop during the teens or early 20s. They can begin as early as the first year of life, or after the age of 60.

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Symptoms

Symptoms of Wolff-Parkinson-White syndrome in an infant include:

  • Lethargy
  • Loss of appetite
  • Rapid, visible pulsations of the chest
  • Shortness of breath
  • An infant with symptoms of Wolff-Parkinson-White can develop heart failure.

In teenager or young adults, symptoms of Wolff-Parkson-White syndrome may include:

  • A sudden rapid heartbeat (paroxysmal supraventricular tachycardia) that often begins during exercise, lasting anywhere from a few seconds to several hours
  • Fainting
  • Rapid or irregular heartbeats (arrhythmia)
  • In young, physically people, these episodes usually cause few symptoms.

Later in life, if you have paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome, you will have more symptoms such as fainting, shortness of breath and chest pain.

Atrial fibrillation may be a particular danger if a person has Wolff-Parkinson-White syndrome. The extra electrical pathway can send impulses to the ventricles much faster than the normal pathway through the atrioventricular node. As a result, the ventricles contract at an extremely fast rate. This makes the heart very inefficient at pumping blood and can be life-threatening. Such a rapid heart rate can also build into ventricular fibrillation, which is fatal unless treated immediately. On rare occasions, Wolff-Parkinson-White syndrome can lead to a rapid, life-threatening heart rate during atrial fibrillation.

Causes and Risk Factors

Wolff-Parkinson White syndrome is a birth defect.

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Diagnosis

A doctor will order an electrocardiogram to identify the abnormal pattern of electrical activity in the heart that Wolff-Parkinson-White syndrome causes.

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Treatments

During an episode of rapid heart rate due to Wolff-Parkinson-White syndrome, doctors can do one of several things that will stimulate the vagus nerve to slow the heart rate. This is most effective when the methods are used soon after the arrhythmia starts.

If this approach does not work, antiarrhythmic drugs such as Verapamil or Adenosine can be given intravenously to stop the arrhythmia. These drugs must then be taken indefinitely to prevent future episodes of rapid heart rate.

In infants and children younger than 10 years, Digoxin may be given to bring episodes of rapid heart beating due to Wolff-Parkinson-White syndrome under control. Usually this drug is stopped before a person with this syndrome reaches puberty. Adults with Wolff-Parkinson-White syndrome are at greater risk of developing atrial fibrillation that degenerates into ventricular fibrillation.

The extra electrical pathway can be destroyed using radiofrequency ablation. This has a high rate of success and is particularly helpful in cases where a young person might otherwise have to take antiarrhythmic drugs for the rest of his or her life.