In Wolff-Parkinson-White (WPW) syndrome, an extra signaling pathway between the heart's upper and lower chambers causes a fast heartbeat (tachycardia). WPW syndrome is a heart condition present at birth (congenital heart defect). It is fairly rare.
Wolff-Parkinson-White syndrome (type A) complicated by heart block in both normal and accessory pathways.
In Wolff-Parkinson-White syndrome, antegrade conduction occurs over an accessory pathway. If atrial fibrillation, develops this is a medical emergency as very rapid ventricular rates can develop. and Atrial Fibrillation. Symptoms include palpitations and sometimes weakness, effort intolerance, dyspnea, and presyncope.
This case indicates that ventricular pre-excitation can provoke a functional cardiac murmur and calls for caution in ascribing systolic murmurs in patients with WPW syndrome to organic heart disease.
In most cases, the cause of Wolff-Parkinson-White syndrome is unknown. A small percentage of all cases are caused by mutations in the PRKAG2 gene. Some people with these mutations also have features of hypertrophic cardiomyopathy, a form of heart disease that enlarges and weakens the heart (cardiac) muscle.
DiagnosisElectrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. ... Holter monitor. This portable ECG device is worn for a day or more to record the heart's rate and rhythm during daily activities.Event recorder. ... Electrophysiological (EP) study.
WPW is not a dangerous disease for most people. You can manage or correct the condition with treatment. The biggest risk is for sudden death from a heart attack, which tachycardia can cause. However, this is extremely rare, occurring in less than one-half of 1 percent of cases.
The use of digoxin or verapamil for long-term therapy appears to be contraindicated for many patients with WPW syndrome, because these medications may enhance antegrade conduction through the AP by increasing the refractory period in the AV node.
Classic ECG findings that are associated with WPW syndrome include the following: Presence of a short PR interval (<120 ms) A wide QRS complex longer than 120 ms with a slurred onset of the QRS waveform, termed a delta wave, in the early part of QRS. Secondary ST-T wave changes (see the image below)