Wolff-Parkinson-White
| Wolff–Parkinson–White syndrome | |
|---|---|
| Synonyms | WPW pattern, Ventricular pre-excitation with arrhythmia, auriculoventricular accessory pathway syndrome |
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| A characteristic "delta wave" seen in a person with Wolff–Parkinson–White syndrome. Note the short PR interval. | |
| Specialty | Cardiology |
| Symptoms | Abnormally fast heartbeat, palpitations, shortness of breath, lightheadedness, loss of consciousness |
| Complications | Cardiomyopathy, stroke, sudden cardiac death |
| Usual onset | Birth |
| Causes | Accessory pathway in the heart |
| Diagnostic method | Electrocardiogram shows a short PR interval and delta wave |
| Treatment | Watchful waiting, medications, radiofrequency catheter ablation |
| Prognosis | Without symptoms 0.5% (children), 0.1% (adults) risk of death per year |
| Frequency | 0.2% |
| Classification |
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| External resources |
Wolff–Parkinson–White syndrome (WPW) is a disorder due to a specific type of problem with the electrical system of the heart which has resulted in symptoms. About 40% of people with the electrical problem never develop symptoms. Symptoms can include an abnormally fast heartbeat, palpitations, shortness of breath, lightheadedness, or syncope. Rarely cardiac arrest may occur. The most common type of irregular heartbeat that occurs is known as paroxysmal supraventricular tachycardia.
The cause of WPW is typically unknown. A small number of cases are due to a mutation of the PRKAG2 gene which may be inherited from a person's parents in an autosomal dominant fashion. The underlying mechanism involves an accessory electrical conduction pathway between the atria and the ventricles. It is associated with other conditions such as Ebstein anomaly and hypokalemic periodic paralysis. Diagnosis is typically when an electrocardiogram (ECG) show a short PR interval and a delta wave. It is a type of pre-excitation syndromes.
WPW syndrome is treated with either medications or radiofrequency catheter ablation. It affects between 0.1 and 0.3% in the population. The risk of death in those without symptoms is about 0.5% per year in children and 0.1% per year in adults. In those without symptoms ongoing observation may be reasonable. In those with WPW complicated by atrial fibrillation, cardioversion or the medication procainamide may be used. The condition is named after Louis Wolff, John Parkinson, and Paul Dudley White who described the ECG findings in 1930.
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