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Wolff-Parkinson-White syndrome

C. A. V. Nogueira, M.D. |
Wolff-Parkinson-White syndrome occurs when an abnormal electrical pathway in the heart causes abnormally fast heart beating.

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Imagine the electrical water pump: Electricity travel along an electrical wire and they stimulate the engine to work and pump water. The same is true for the heart: electric signals stimulate your heart to pump blood around your body. For the heart to work properly those signals must be synchronized; every one of them has its own task.

There is a group of specialized cells (atrioventricular node) which conducts electrical impulses from the heart's upper chambers (atria) to the lower chambers (ventricles). Electrical signals move through the atrioventricular node during every heartbeat - they stimulate lower chamber to contract a little bit later than upper.

There are people who were born with an extra connection which allows electrical signals to bypass the atrioventricular node. That means the signals travel from the heart's upper chambers to the lower chambers faster than normal. Even worse, that extra path which shouldn't be there can cause signals to travel in the wrong direction which in turn causes heart to pump like crazy: irregularly and too often. In that case we say that the patient has Wolff-Parkinson-White syndrome (WPW).

The patient with WPW syndrome feels their heart is beating very fast, racing and pounding. Wolff-Parkinson-White syndrome occurs in about 4 out of 100,000 people, and is one of the most common causes of fast heart rate disorders. The speed of the heartbeats differs from person to person so sometimes it's hard to diagnose the problem. However, a simply ECG (electrocardiography) can discover this disorder, that's a good news. The bad one is that this syndrome is often discovered in otherwise young and healthy persons. Many patients are being diagnosed with WPW during the routine health check at the age of 11-50.

While one patient may have isolated episodes of rapid heart beating and short breath the other will may have the symptoms two or three times a week, and the third will have no symptoms at all. That means that WPW in most cases will be discovered just by pure accident.

So, what can be done? First, people without symptoms don't need treatment. Second, people with sporadic episodes can be treated with drugs. In that case the patient is given drugs intravenously and in some patients the syndrome may require pills to the rest of their life.

However, sometimes drugs don't work. The doctor will then suggest a small surgical procedure. A flexible tube is entered to the place where the problem exists. Then, using radio frequency, that problematic tissue - the extra connection - is destroyed.