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When there is a presence of an extra electrical pathway between the heart's upper and lower chambers, there could be a rapid heartbeat  . Although rare, this condition is known as Wolff-Parkinson-White (WPW) syndrome. The extra pathway is present at birth and leads to periods of rapid heart rate (tachycardia)  . This syndrome is the primary cause of fast heart rate problems in kids.
This congenital condition was first described by Wolff, Parkinson and White in the year 1930 when they came across patients who showed characteristic abnormalities on ECG. Read on to know more about the causes, symptoms, diagnosis and treatment of this rare condition.
What Is Wolff-Parkinson-White (WPW) Syndrome?
When you feel that your heart has skipped a beat, it is a strange feeling known as palpitation. It is usually harmless. Nevertheless, it can also indicate a possible problem such as WPW syndrome. It is a rare condition where the heart beats irregularly (arrhythmia)  . The presence of an extra electrical pathway in people with WPW syndrome causes abnormal heartbeats. It can lead to serious conditions such as supraventricular tachycardia  (the ventricles beat very quickly).
WPW syndrome often occurs with other structural abnormalities of the heart. The most common heart defect associated with this condition is Ebstein anomaly (the valve that allows blood to flow from the right atrium to the right ventricle is affected)  .
Causes Of Wolff-Parkinson-White (WPW) Syndrome
Under normal conditions, the electrical signals follow a specific pathway through the heart. This allows the heart to beat regularly. This lets the heart not have extra beats or beats happening too soon.
WPW syndrome is a congenital heart defect (a person is born with it). Most of the times it does not run in families, but in some rare cases, parents can pass it down to their children  . Moreover, even a person who is born with this condition might not find out that they have it at least until they are in their teens.
Symptoms Of Wolff-Parkinson-White (WPW) Syndrome
The symptoms can begin to show at any age - from infancy through adult years. The following are some of the common symptoms of this illness  .
- Loss of consciousness
- Shortness of breath (dyspnea)
- Racing feeling in your chest
- Irritability and poor eating in children.
Most of the episodes of fast heartbeat begin suddenly and last for a few seconds or several hours. Caffeine or other stimulants may trigger it for some people  . In serious cases, the symptoms can be extreme chest pain and chest tightness.
However, it is noteworthy to know that some people might have WPW syndrome without any symptoms at all.
Diagnosis Of Wolff-Parkinson-White (WPW) Syndrome
Once the symptoms are noted, your healthcare practitioner will ask you to see a cardiologist or heart specialist. The patient's past and current heart-related issues are taken into consideration. A thorough physical examination is conducted that includes checking the heart rate and blood pressure. The following diagnostic tests might be conducted:
- Electrocardiography: Checks the electrical activity of the heart 
- Holter monitoring: Checks your heart over a long period of time. The patient will need to wear a monitor that would record the heart rhythm for about 24 hours  .
- Electrophysiological studies: This is done to locate and learn more about the patient's arrhythmia  . Flexible, thin tubes tipped with electrodes are threaded through the patient's blood vessels to various spots in the heart.
Treatment For Wolff-Parkinson-White (WPW) Syndrome
The severity and frequency of symptoms are the determining factor behind the treatment procedure followed by the doctor. In case symptoms are minimal, you might just have to take oral medicines apart from going for follow-up visits and tests. If medicines aren't enough, you might be sent for a procedure called catheter ablation  . This is a procedure that involves getting rid of the areas of the heart tissue that cause irregular beats.
The ideal goal of treating WPW syndrome is to slow a fast heart rate when it occurs and to prevent the future occurrence of such episodes. The treatment options include the following:
- Medications: Injection of an anti-arrhythmic medication  might work well in reducing a fast heartbeat. Medicine to slow the heart rate might also be prescribed.
- Vagal manoeuvers  : These involve simple physical movements such as bearing down such that you are having a bowel movement, coughing or putting an ice pack on your face. Such movements affect a nerve and help in the regulation of heartbeat (vagus nerve). The doctor might recommend performing vagal manoeuvers to help in slowing down a rapid heartbeat whenever it occurs.
- Cardioversion: Paddles or patches might be placed on your chest to electrically shock your heart to restore the normal rhythm  . This is usually used only once medication and manoeuvers seem to fail.
Radiofrequency catheter ablation: Catheters are threaded through blood vessels to your heart. Electrodes at the catheters tops will be heated to destroy the extra electrical pathway (the one that causes the condition)  . This procedure can permanently correct the heart-rhythm problems in most of the patients.
Living With Wolff-Parkinson-White (WPW) Syndrome
WPW will not affect your daily life if you have slight or no symptoms at all, except for the fact that you will have to go to the doctor's clinic for extra checkups. However, the presence of some of the symptoms might pose challenges. For example, if you tend to faint often, then you might not want to drive a car or take part in certain other activities. Nevertheless, talking to your doctor and getting all your scheduled tests on time will ensure that your condition and its associated symptoms are kept under check.