WPW syndrome: Rare cause of sudden cardiac death in young people - Symptoms and causes (2024)

Overview

Wolff-Parkinson-White (WPW) syndrome

WPW syndrome: Rare cause of sudden cardiac death in young people - Symptoms and causes (1)

Wolff-Parkinson-White (WPW) syndrome

In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between the heart's upper chambers and lower chambers causes a fast heartbeat.

Wolff-Parkinson-White (WPW) syndrome is a heart condition present at birth. That means it's a congenital heart defect. People with WPW syndrome have an extra pathway for signals to travel between the heart's upper and lower chambers. This causes a fast heartbeat. Changes in the heartbeat can make it harder for the heart to work as it should.

WPW syndrome is fairly rare. Another name for it is preexcitation syndrome.

The episodes of fast heartbeats seen in Wolff-Parkinson-White syndrome usually aren't life-threatening. But serious heart problems can occur. Rarely, the syndrome may lead to sudden cardiac death in children and young adults.

Treatment of WPW syndrome may include special actions, medicines, a shock to the heart or a procedure to stop the irregular heartbeats.

Symptoms

The heart rate is the number of times the heart beats each minute. A fast heart rate is called tachycardia (tak-ih-KAHR-dee-uh).

The most common symptom of Wolff-Parkinson-White (WPW) syndrome is a heart rate greater than 100 beats a minute.

In WPW syndrome, the fast heartbeat can begin suddenly. It may last a few seconds or several hours. Episodes may occur during exercise or while at rest.

Other symptoms of WPW syndrome may depend on the speed of the heartbeat and the underlying heart rhythm disorder.

For example, the most common irregular heartbeat seen with WPW syndrome is supraventricular tachycardia (SVT). During an episode of SVT, the heart beats about 150 to 220 times a minute, but it can occasionally beat faster or slower.

Some people with WPW syndrome also have a fast and chaotic heart rhythm disorder called atrial fibrillation.

In general, symptoms of WPW syndrome include:

  • Rapid, fluttering or pounding heartbeats.
  • Chest pain.
  • Difficulty breathing.
  • Dizziness or lightheadedness.
  • Fainting.
  • Fatigue.
  • Shortness of breath.
  • Anxiety.

Symptoms in infants

Infants with WPW may have other symptoms, such as:

  • Blue or gray skin, lips and nails. These changes may be harder or easier to see depending on skin color.
  • Restlessness or irritability.
  • Rapid breathing.
  • Poor eating.

Some people with an extra electrical pathway don't have symptoms of a fast heartbeat. This condition is called Wolff-Parkinson-White (WPW) pattern. It's often discovered by chance during a heart test.

When to see a doctor

Many things can cause a fast heartbeat. It's important to get a prompt diagnosis and care. Sometimes a fast heartbeat isn't a concern. For example, the speed of the heartbeat may increase with exercise.

If you feel like your heart is beating too fast, make an appointment to see a healthcare professional.

Call 911 or your local emergency number if you have any of the following symptoms for more than a few minutes:

  • Sensation of a fast or pounding heartbeat.
  • Difficulty breathing.
  • Chest pain.

Request an appointment

Causes

Typical heartbeat

WPW syndrome: Rare cause of sudden cardiac death in young people - Symptoms and causes (2)

Typical heartbeat

In a typical heart rhythm, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and then passes into the ventricles, causing them to contract and pump out blood.

Wolff-Parkinson-White (WPW) syndrome is a heart condition present at birth. That means it's a congenital heart defect. Researchers aren't sure what causes most types of congenital heart defects. WPW syndrome may occur with other congenital heart defects, such as Ebstein anomaly.

Rarely, WPW syndrome is passed down through families. Your healthcare team may call this inherited or familial WPW syndrome. It is associated with a thickened heart muscle, called hypertrophic cardiomyopathy.

To understand the causes of WPW syndrome, it may be helpful to know how the heart typically beats.

The heart has four chambers.

  • The two upper chambers are called the atria.
  • The two lower chambers are called the ventricles.

Inside the upper right heart chamber is a group of cells called the sinus node. The sinus node makes the signals that start each heartbeat.

The signals move across the upper heart chambers. Next, the signals arrive at a group of cells called the atrioventricular (AV) node, where they usually slow down. The signals then go to the lower heart chambers.

In a typical heart, this signaling process usually goes smoothly. The resting heart rate is about 60 to 100 beats a minute.

In WPW syndrome, an extra electrical pathway connects the upper and lower heart chambers, allowing heart signals to bypass the AV node. As a result, the heart signals don't slow down. The signals get excited, and the heart rate gets faster. The extra pathway also can cause heart signals to travel backward. This causes an uncoordinated heart rhythm.

Complications

WPW syndrome has been linked to sudden cardiac death in children and young adults.

By Mayo Clinic Staff

Dec. 13, 2023

WPW syndrome: Rare cause of sudden cardiac death in young people - Symptoms and causes (2024)

FAQs

WPW syndrome: Rare cause of sudden cardiac death in young people - Symptoms and causes? ›

In WPW syndrome, an extra electrical pathway connects the upper and lower heart chambers, allowing heart signals to bypass the AV node. As a result, the heart signals don't slow down. The signals get excited, and the heart rate gets faster. The extra pathway also can cause heart signals to travel backward.

What triggers WPW syndrome? ›

Some people may have episodes on a daily basis, while others may only experience them a few times a year. They normally occur randomly, without any identifiable cause, but they can sometimes be triggered by strenuous exercise or drinking a lot of alcohol or caffeine.

What is the life expectancy of someone with WPW syndrome? ›

Implications for practice: A thorough patient history and physical examination can aid the practitioner in identifying patients who may have WPW syndrome. With appropriate referral, treatment, and patient education, patients with WPW syndrome can expect to have a normal life expectancy and good quality of life.

What does a WPW episode feel like? ›

You may have a fast heart rate or feel a fluttering in your chest (palpitations), feel chest pain, feel light-headed or dizzy, or faint. When you have these symptoms, it is called an episode. Some people do not have symptoms. Very rarely, a WPW episode can trigger a heart rhythm that can cause death.

What should you avoid with WPW syndrome? ›

In particular, avoid adenosine, diltiazem, verapamil, and other calcium channel blockers and beta-blockers. They can exacerbate the syndrome by blocking the heart's normal electrical pathway and facilitating antegrade conduction via the accessory pathway.

What are the high risk features of WPW? ›

High-risk features on clinical evaluation include male sex, WPW pattern detected in the first two decades of life, history of atrial fibrillation (AF), arrhythmic symptoms (especially syncope), congenital heart disease (e.g., Ebstein's anomaly), or familial WPW syndrome.

What have most deaths from WPW syndrome been associated with? ›

Ventricular fibrillation is the most common cause of sudden death in WPW patients.

What causes sudden death in WPW patients? ›

Ventricular fibrillation is the most common cause of sudden death in WPW patients. It is difficult to diagnose arrhythmia related sudden death at postmortem without an antemortem electrocardiogram.

Does WPW damage the heart? ›

Another name for it is preexcitation syndrome. The episodes of fast heartbeats seen in Wolff-Parkinson-White syndrome usually aren't life-threatening. But serious heart problems can occur. Rarely, the syndrome may lead to sudden cardiac death in children and young adults.

What happens if WPW goes untreated? ›

If left untreated, WPW syndrome can cause the following problems: Heart failure. Serious arrhythmias, including atrial fibrillation. Cardiac arrest, which can be fatal and is more common in boys and men and in people who have other heart conditions.

What is the drug of choice for WPW? ›

The drug of choice for the treatment of regular supraventricular (reciprocating) tachycardia with narrow QRS complexes, which is the most common arrhythmia in the WPW syndrome, is propranolol. Digitalis is almost equally effective in this case.

Is WPW considered a disability? ›

505 (2009). The Veteran's Wolff-Parkinson-White syndrome is rated 60 percent disabling, effective April 19, 2006, under Diagnostic Code 7011, used for rating sustained ventricular arrhythmias. 38 C.F.R. § 4.118, Diagnostic Code 7011 (2011).

Does WPW cause anxiety? ›

If you have WPW syndrome, you may experience: Unexplained anxiety. Palpitations (rapid thumping or fluttering) in the chest. Feeling tired (fatigue)

How rare is WPW? ›

WPW affects one to three of every 1,000 people worldwide.

Can WPW make you tired? ›

WPW syndrome is a rapid heartbeat due to an extra electrical pathway connecting the upper and lower chambers of the heart. While some people might not experience WPW syndrome, those who do can experience fainting, tiredness, and shortness of breath.

Can WPW go away? ›

Outlook for Wolff-Parkinson-White syndrome

Radiofrequency ablation or surgery can cure WPW in many people. Usually, people without symptoms have a low risk of having a cardiac arrest. People who have symptoms of tachycardia (fast heart rate) are more likely to have a cardiac arrest.

How do I stop a WPW episode? ›

How is Wolff-Parkinson-White syndrome treated?
  1. You may be able to stop an episode of tachycardia by massaging your neck (never massage both sides at the same time), coughing, or bearing down like you are having a bowel movement. ...
  2. You may be able to take medicine to stop or prevent tachycardia.

Does Wolff-Parkinson-White run in families? ›

Family studies, and more recent molecular genetic investigations, indicate that the Wolff-Parkinson-White (WPW) syndrome and associated preexcitation disorders can have a substantial genetic component.

How do you fix WPW syndrome? ›

If the heart rate does not return to normal with medical treatment, health care providers may use a type of therapy called electrical cardioversion (shock). The long-term treatment for WPW syndrome is very often catheter ablation.

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