Wolff Parkinson White awareness

Overview

Wolff-Parkinson-White (WPW) syndrome is a heart condition you are born with. It happens because there is an extra electrical pathway in the heart that can cause the heart to suddenly beat very fast (a rapid heartbeat called tachycardia).

WPW is not very common. It affects about 1 to 3 in every 1,000 people worldwide.

WPW can affect people of any age, including children and older adults. It is slightly more common in males and may run in some families.

Symptoms

Common symptoms

• Sudden episodes of a racing or pounding heartbeat (palpitations)
• Dizziness or lightheadedness during a fast heart rate
• Shortness of breath or chest discomfort during an episode
• Feeling faint or nearly fainting

Symptoms in children

• Babies may show fussiness, poor feeding, or rapid breathing.
• Older children might complain of a 'fluttering' feeling in the chest or say their heart is 'jumping'.
• Children may look pale, feel tired quickly, or have episodes of fainting.

Symptoms in older adults

• Episodes of a fast heart rate may be less noticeable but can cause confusion or falls.
• Older adults may feel more breathless or tired during an episode.
• Some may have no symptoms at all and are diagnosed during a routine check-up.

Causes

Main causes

• WPW is caused by an extra electrical connection (called an accessory pathway) between the upper and lower chambers of the heart that is present from birth.
• This extra pathway can allow electrical signals to 'short-circuit', leading to a very fast heart rate.

Risk factors

• In most cases, there is no known cause – it occurs by chance.
• Some studies suggest it can run in families, so having a close relative with WPW may slightly increase your chance.

When to see a doctor

See a doctor urgently if:

• If you faint or nearly faint during a fast heartbeat episode.
• If you have chest pain or severe shortness of breath with a fast heartbeat.
• If your heart rate does not slow down on its own within a few minutes and you feel very unwell.

Book a routine appointment if:

• If you notice any episodes of a racing or irregular heartbeat, even if they are mild.
• If you have been told you have an abnormal ECG and want to understand more.
• If you have a family history of WPW or sudden cardiac death.

Diagnosis

WPW is usually diagnosed with a simple, painless test called an electrocardiogram (ECG or EKG) that records the electrical activity of your heart.

Tests that may be done

• Electrocardiogram (ECG) – the main test to see the extra pathway.
• Holter monitor – a portable ECG you wear for 24 to 48 hours to catch episodes that come and go.
• Event recorder – a device you wear for weeks to record your heart rhythm when you have symptoms.
• Electrophysiology study (EPS) – a more detailed test done in hospital to map the exact location of the extra pathway and check if it is likely to cause problems.

What to expect at your appointment

If you are referred to a heart specialist (cardiologist), they will discuss your symptoms and do an ECG. You may be asked to wear a heart monitor at home. An EPS is usually done only if treatment (like catheter ablation) is being considered. Most tests are not painful and carry very low risk.

Treatment

Not everyone with WPW needs treatment. If you have no symptoms or only very mild ones, your doctor may recommend simply monitoring you. If episodes are bothersome or there is a higher risk of serious heart rhythm problems, treatment can help control or eliminate the extra pathway.

Self-care at home

• Avoid triggers that may set off episodes, such as caffeine, alcohol, or illegal stimulants.
• Learn simple techniques to slow your heart rate during an episode, like bearing down as if having a bowel movement (Valsalva maneuver) – but only if a doctor has shown you how.
• Keep a record of your episodes – when they happen, how long they last, and what you were doing.

Medical treatments

Medications called antiarrhythmics may be prescribed to help prevent rapid heartbeats. These are taken either only when symptoms occur or regularly to reduce episodes. Your doctor will choose the safest option based on your health and the type of extra pathway.

When is surgery considered?

A procedure called catheter ablation is often used to permanently fix the extra pathway. A thin flexible tube is guided through a blood vessel to the heart and a small area of tissue is heated or frozen to destroy the abnormal pathway. It is very effective and has a high success rate with a short recovery time. Open heart surgery is rarely needed.

Living with this condition

Most people with WPW can lead a normal, active life. You may need to be aware of what triggers your episodes and avoid them. If you have had ablation, you can usually return to all activities within a week or two after the procedure.

Lifestyle tips

• Try to manage stress, as strong emotions can sometimes trigger episodes.
• Get enough sleep and stay well hydrated.
• Avoid activities that you know trigger your symptoms, if you have identified them.

Diet and exercise

A heart-healthy diet (plenty of fruits, vegetables, whole grains) is always a good idea. Exercise is generally safe and encouraged, but if you have active WPW with episodes, talk to your doctor before starting intense sports or competitive athletics. Most people with WPW can exercise normally after treatment.

Mental health and emotional wellbeing

Living with a condition that can cause sudden scary symptoms may cause anxiety or worry. It is normal to feel concerned. Talk to your healthcare provider about your feelings, and consider relaxation techniques or counseling if needed.

Prevention

WPW itself cannot be prevented because it is a condition you are born with. However, you can help prevent episodes by avoiding known triggers and managing stress. Treatment like catheter ablation can eliminate the risk of future episodes.

Screening programmes

WPW is often found during routine ECGs. If you have a family member with WPW, your doctor may suggest an ECG to check for the extra pathway. There is no standard screening for the general population.

Complications

If left untreated

• Frequent episodes of a very fast heart rate can be uncomfortable and affect daily life.
• In rare cases, WPW can lead to a more dangerous heart rhythm called atrial fibrillation, which may increase the risk of stroke.
• Very rarely, a very fast heart rate can lead to sudden cardiac arrest (the heart stops pumping effectively).

Long-term outlook

For most people, WPW is a manageable condition. With proper diagnosis and treatment, the outlook is excellent. Episodes can often be controlled with medications or cured with catheter ablation. Even without symptoms, the risk of serious complications is low. Your healthcare team can help you understand your personal risk and the best plan for you.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.