Diagnosis

Your doctor will likely recommend heart tests to diagnose WPW syndrome, such as:

  • Electrocardiogram (ECG). Small sensors attached to your chest and arms record electrical signals as they travel through your heart. Your doctor can look for patterns among these signals that indicate the presence of an extra electrical pathway in your heart.
  • Portable ECG. Using a portable ECG device at home provides more information about your heart rate. A Holter monitor records your heart activity for 24 hours. An event recorder monitors heart activity when you experience symptoms of a fast heart rate.
  • Electrophysiological testing. Thin, flexible tubes (catheters) tipped with electrodes are threaded through your blood vessels to various spots in your heart. The electrodes can precisely map the spread of electrical impulses during each heartbeat and identify an extra electrical pathway.

Treatment

Treatment depends on several factors, including the severity and frequency of your symptoms.

If you have the WPW pathway but don't have any symptoms, you probably won't need treatment. If treatment is needed, the goal is to slow a fast heart rate when it occurs and to prevent future episodes.

Treatment options include:

  • Vagal maneuvers. These simple physical movements — which include coughing, bearing down as if you are having a bowel movement and putting an ice pack on your face — affect a nerve that helps regulate your heartbeat (vagus nerve). Your doctor may recommend performing vagal maneuvers to help slow a rapid heartbeat when it occurs.
  • Medications. If vagal maneuvers don't stop the fast heartbeat, you may need an injection of an anti-arrhythmic medication. Your doctor also may recommend a medication that can slow the heart rate.
  • Cardioversion. Your doctor may use paddles or patches on your chest to electrically shock your heart and help restore a normal rhythm. Cardioversion is typically used when maneuvers and medications aren't effective.
  • Radiofrequency catheter ablation. Thin, flexible tubes (catheters) are threaded through blood vessels to your heart. Electrodes at the catheter tips are heated to destroy (ablate) the extra electrical pathway causing your condition. Radiofrequency ablation permanently corrects the heart-rhythm problems in most people with WPW syndrome.

Preparing for your appointment

What you can do

  • Write down your symptoms, including any that may seem unrelated to your heart.
  • Make a list of all your medications, vitamins or supplements.
  • Write down your key medical information, including other diagnosed conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Write down questions to ask your doctor.

Questions to ask your doctor

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

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may make time to go over points you want to spend more time on. Your doctor might ask:

  • When did you first begin experiencing symptoms? How severe are they?
  • How often have you experienced a fast heartbeat?
  • How long have the episodes lasted?
  • Does anything such as exercise, stress or caffeine seem to trigger or worsen the episodes?
  • Do you have a family history of heart disease?