Wolff-Parkinson-White (WPW) syndrome

Diagnosis

If you have a fast heartbeat, your health care provider will likely recommend tests to check for WPW syndrome, such as:

• Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. Sticky patches (electrodes) are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. A health care provider can look for patterns among the heart signals that suggest an extra electrical pathway in 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. This wearable ECG device is used to detect infrequent arrhythmias. You press a button when symptoms occur. An event recorder is typically worn for up to 30 days or until you have an arrhythmia or symptoms.
• Electrophysiological (EP) study. An EP study may be recommended to distinguish between WPW syndrome and WPW pattern. One or more thin, flexible tubes (catheters) are guided through a blood vessel, usually in the groin, to various spots in the heart. Sensors on the tips of the catheters record the heart's electrical patterns. An EP study allows a health care provider to see how electrical signals spread through the heart during each heartbeat.

Treatment

Treatment for Wolff-Parkinson-White (WPW) syndrome depends on the severity and frequency of symptoms and the type of heart rhythm problem (arrhythmia) causing the fast heart rate.

The goals of treatment are to slow a fast heart rate when it occurs and to prevent future episodes. Treatment options for a fast heart rate include:

• Vagal maneuvers. Simple but specific actions such as coughing, bearing down as if having a bowel movement or putting an ice pack on the face can help slow down the heart rate. Your health care provider may ask you to perform these actions during an episode of a fast heartbeat. These actions affect the vagus nerve, which helps control the heartbeat.
• Medications. If vagal maneuvers don't stop a fast heartbeat, you might need medications to control the heart rate and restore the heart rhythm. Medications may need to be given by IV.
• Cardioversion. Paddles or patches on the chest are used to electrically shock the heart and help reset the heart rhythm. Cardioversion is typically used when vagal maneuvers and medications don't work.
• Catheter ablation. In this procedure, the health care provider inserts a thin, flexible tube (catheter) through a blood vessel, usually in the groin, and guides it to the heart. Sometimes more than one catheter is used. Sensors on the tip of the catheter use heat (radiofrequency energy) to create tiny scars in the heart. The scar tissue permanently blocks faulty electrical signals, restoring a regular heartbeat. Catheter ablation doesn't require surgery to access the heart, but it may also be done at the same time as other heart surgeries.

People with an extra signaling pathway but no symptoms (WPW pattern) usually don't need treatment.

Lifestyle and home remedies

If you have Wolff-Parkinson-White (WPW) syndrome or episodes of a fast heart rate (tachycardia), your health care provider will likely recommend following a heart-healthy lifestyle. Take these steps:

• Avoid caffeine or other stimulants.
• Don't smoke.
• Eat a healthy diet.
• Get regular exercise.
• Limit or avoid alcohol.
• Maintain a healthy weight.
• Manage emotional stress.

Preparing for your appointment

Here's some information to help you get ready for your appointment.

What you can do

When you make the medical appointment, ask if you need to do anything in advance, such as restrict your or your child's diet.

Write down the following information and take it with you to the appointment:

• Your or your child's symptoms, including any that may seem unrelated to the heart, and when they began
• All medications, vitamins or other supplements you or your child takes, including doses
• Important medical details, including other diagnosed conditions
• Key personal information, including any recent life changes or stressors
• Questions to ask your health care provider

Questions to ask your doctor

For WPW syndrome, some basic questions to ask your health care provider include:

• What's the most likely cause of my symptoms?
• What tests do I need?
• What treatments can help?
• What are the risks of WPW syndrome?
• How often will I need follow-up appointments?
• Do I need to restrict activities?
• How will other conditions that I have or medications I take affect my heart condition?

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

• How severe are the symptoms?
• How often does the fast heartbeat occur?
• How long do episodes last?
• Does anything, such as exercise, stress or caffeine, seem to trigger the episodes or make symptoms worse?
• Is there a family history of tachycardia or heart disease?