Wolff-Parkinson-White Syndrome: Symptoms, Causes, Treatment

An asymptomatic preexcitation ECG pattern differs from the symptomatic syndrome. Having no palpitations does not remove the need to assess the pathway’s risk.

Related reading: Types of supraventricular tachycardia.

Abrupt palpitations may accompany dizziness, breathlessness, chest discomfort or fainting. Some people are diagnosed incidentally without symptoms.

The accessory pathway is present from birth, usually without an identifiable inherited cause. It bypasses normal conduction and may form part of a rapid electrical circuit.

Any age can be affected; male sex and some congenital heart defects are associated. Familial cases occur but are uncommon. The diagnostic label alone does not determine whether ablation is needed.

Assessment includes ECGs and symptom review, sometimes ambulatory monitoring, exercise testing and heart imaging. An electrophysiology study can characterize the pathway and guide ablation decisions.

A specialist selects observation, catheter ablation or suitable medicine. Acute care depends on the rhythm: AV-node-slowing drugs such as adenosine and digoxin are dangerous in preexcited atrial fibrillation.

Episodes are often controllable, but dangerous rhythms can occur, particularly when rapid atrial fibrillation conducts through the accessory pathway. Individual evaluation establishes risk.

There is no proven way to prevent the pathway forming. Keep your ECG report, tell clinicians your diagnosis and discuss medicines and activity with an electrophysiologist; do not self-treat palpitations.