Wolff Parkinson White
What is Wolff Parkinson White (WPW)?
Wolff Parkinson White is a condition in which there is an extra electrical connection between the top chambers of the heart (the atria) and the bottom chambers of the heart (the ventricles). This extra connection is called an accessory pathway. Patients with WPW have a characteristic appearance on their EKG in which the ventricular signal (the QRS) is wider than normal. Patients with WPW also have a characteristic signal called a “delta wave” that is present on their EKG that is part of the ventricular signal.
What are the symptoms of WPW?
Many patients with WPW do not feel anything. However, many patients with WPW are more susceptible to having abnormal heart rhythms (arrhythmias) such as supraventricular tachycardia (SVT). If the accessory pathway is able to conduct electrical activity, an arrhythmia that is called reentry can occur in which electrical activity conducts down the normal electrical system and back up the accessory pathway. Patients with WPW also have a higher risk of developing atrial fibrillation and sudden cardiac death.
What is the treatment of WPW?
The treatment is usually an Electrophysiology Study and Ablation of the accessory pathway. During the Electrophysiology Study, the electrical properties of the accessory pathway are analyzed carefully. Some patients elect to take medications. However, medications that affect the atrioventricular node (AVN) such as metoprolol, atenolol, diltiazem, verapamil, or digoxin should be used very carefully in patients with WPW. Patients may discuss other options with their cardiologist.