Wolff-Parkinson-White Pathways

Patients with Wolff-Parkinson-White (WPW) pathways have extra electrical pathways between heart chambers (i.e. between the atria and the ventricles), known as accessory pathways (short cut) that look like normal heart muscle, but they may conduct impulses faster than normal and/or conduct impulses in both directions instead of normal one direction from the atria to the ventricles. These symptoms occur in about 50 percent of people with WPW; some may have atrial fibrillation, a common irregular heart rhythm distinguished by disorganized, rapid, and irregular heart rhythm. The greatest concern for people with WPW is the possibility of having atrial fibrillation with a fast ventricular response that worsens to a life-threatening arrhythmia. Most people experience symptoms between the ages of 11 and 50 years old. The highest incidence occurs between the ages of 30 and 40 years old. In the general population, men have a higher incidence of WPW than women do, and there is a higher incidence of multiple accessory pathways in men.
Patients who have such symptoms because of this abnormality are said to have the WPW syndrome. During tachycardia (when heart pulses are faster than normal), patients may experience sudden heart pounding, fluttering, racing feeling in the chest, shortness of breath, dizziness, lightheadedness, anxiety, fainting, or rarely sudden death.
Some patients have the WPW pathway, but no experience in heart beats that are faster than normal. They do not have WPW syndrome, but may develop it at some point. These patients are said to have a WPW pattern, which can be detected on a routine electrocardiogram (ECG). They do not need treatment.
However, patients with WPW syndrome require treatment when or if they have an episode of tachycardia due to the serious potential risks. Treatment focuses on stopping the tachycardia and preventing its from recurring. The most common treatment options for Wolff-Parkinson-White syndrome are medications and catheter radiofrequency ablation, a minimally-invasive procedure to remove the abnormal, extra electrical heart pathway. Rarely, open-heart surgery may be performed if patients have other heart conditions in addition to WPW syndrome.