My wife, who is 50, started to experience episodes of rapid heart palpitations and dizziness. After a number of cardiac investigations she was told she has a condition called Wolff-Parkinson-White syndrome? Can you explain what this is?
Wolff-Parkinson-White (WPW) syndrome is a disorder in which there is an extra electrical connection between the atria and the ventricles in the heart.
The syndrome is the most common of several disorders that involve an extra pathway between the heart’s top and bottom chambers.
Symptoms can include episodes of tachycardia (rapid heart rhythm), dizziness, chest palpitations, fainting or, rarely, cardiac arrest.
While Wolff-Parkinson-White syndrome is present from birth, for many the associated heart rhythm disorders (arrhythmias) may only become apparent as they get older. Some sufferers with WPW never experience tachycardia or other symptoms.
About 80 per cent of people with symptoms first notice them between the ages of 11 and 50.
Her palpitations only came when she exercised. Is this normal?
When teenagers or people in their early 20s first experience an arrhythmia due to this syndrome, palpitations can begin suddenly, often during exercise.
The episode may last for only a few seconds or it may persist for several hours.
In older people episodes of arrhythmia due to Wolff-Parkinson- White syndrome tend to produce more symptoms, such as fainting, shortness of breath and chest pain.
Because Wolff-Parkinson-White syndrome changes the pattern of electrical activation in the heart, it can be diagnosed using electrocardiography (ECG). This test records the electrical activity of the heart.
She’s been put on medication and this does seem to be doing the job. However, what happens if the drugs no longer work or her symptoms return?
People without symptoms usually don’t need treatment. People with episodes of tachycardia can often be treated with medication.
Where medication is not effective, a procedure may be required to interrupt the abnormal pathway.
The most common procedure used is radio frequency or catheter ablation.
A flexible tube called a catheter is guided through a vein to the heart where the problem is located. Then that tissue is destroyed with radiofrequency energy, stopping the electrical pathway. Successful treatment using ablation ends the need for medication.
The decision to use medication or an ablation procedure will depend on the severity and frequency of symptoms, the risk for future arrhythmias and the preference of the patient.
Once the condition has been identified and treated appropriately, people with WPW syndrome have an excellent prognosis.