Wolff-Parkinson-White (WPW) syndrome

Diagnosis

To diagnose Wolff-Parkinson-White (WPW) syndrome, a healthcare professional examines you and listens to your heart with a device called a stethoscope. You usually are asked questions about your medical history and symptoms

Tests

Tests may be done to confirm WPW syndrome and look for an underlying cause. Tests may include:

• Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which prints or displays the test results. An ECG shows how slow or how fast the heart is beating. A healthcare professional can look for heartbeat patterns that suggest an extra electrical pathway in the heart.
• Holter monitor. This small, portable ECG device records the heart's activity. It's worn for a day or two while you do your regular activities.
• Event recorder. This device is like a Holter monitor, but it records only at certain times for a few minutes at a time. It's typically worn for about 30 days. You usually push a button when you feel symptoms. Some devices automatically record when an irregular heart rhythm is detected.
• Electrophysiological (EP) study. An EP study may be done to tell the difference between WPW syndrome and WPW pattern. One or more thin, flexible tubes called catheters are guided through a blood vessel, usually in the groin, to various areas in the heart. Sensors on the tips of the catheters record the heart's electrical patterns. An EP study shows how electrical signals spread through the heart during each heartbeat.

Treatment

Treatment for Wolff-Parkinson-White (WPW) syndrome depends on:

• How often symptoms occur.
• How severe the symptoms are.
• The type of irregular heartbeat causing the fast heart rate.

People who have an extra signaling pathway but no symptoms, called WPW pattern, usually don't need treatment.

The goals of WPW syndrome treatment are to:

• Slow a fast heart rate when it occurs.
• Prevent future episodes.

Treatment options may include:

• Vagal maneuvers. These are simple actions that can slow the heartbeat. They include coughing, bearing down as if passing stool and putting an ice pack on the face. Your healthcare team may ask you to do these specific actions during an episode of a fast heartbeat. These actions affect the vagus nerve, which helps control the heartbeat.
• Medicines. If vagal maneuvers don't stop a fast heartbeat, you might need medicines to control the heart rate and restore the heart rhythm. Medicines 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 medicines don't work. It's also possible to do cardioversion with medicines.
• Catheter ablation. In this procedure, a doctor inserts one or more thin, flexible tubes called catheters into an artery, usually in the groin. The doctor guides them to the heart. Sensors on the tip of the catheters use heat or cold energy to create tiny scars in the heart. The scars block irregular electrical signals and restore the heart's rhythm. Catheter ablation may be done at the same time as other heart surgeries.

Lifestyle and home remedies

If you have WPW syndrome or any type of heart disease, your healthcare team usually recommends following a heart-healthy lifestyle. Take these steps:

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

Coping and support

If you have a plan in place to manage an episode of a fast heartbeat, you may feel calmer and more in control when one occurs. Ask your healthcare professional:

• How to take your pulse and what heart rate is best for you.
• When and how to use vagal maneuvers, if appropriate.
• When to make an appointment for a health checkup.
• When to seek emergency care.

Preparing for your appointment

If you have WPW syndrome, you may be referred to a doctor trained in heart problems present at birth. This type of healthcare professional is called a congenital cardiologist.

Because there's often a lot to discuss, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment.

What you can do

Make a list ahead of time that you can share with your healthcare team. Your list should include details about the following:

• Any symptoms, including those that may seem unrelated to the heart or heartbeat.
• Important personal information, including any major stresses or recent life changes.
• All current medicines and their dosages, including vitamins and supplements and medicines bought without a prescription.
• Questions to ask the healthcare team.

Questions to ask your doctor

For WPW syndrome, some basic questions to ask your healthcare team include:

• What is the likely cause of my fast heart rate?
• 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 avoid any activities?
• How will other conditions that I have or medicines I take affect my heart condition?

What to expect from your doctor

Your healthcare professional 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 irregular heartbeats or other heart disease?

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