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Normally, the electrical signals that coordinate the heartbeat travel through the atria (two top chambers of the heart) to the ventricles (two bottom chambers). These signals travel through the atrioventricular (AV) node, which is the electrical pathway connecting the atria and ventricles.
In people with Wolff-Parkinson-White syndrome, there is an extra (accessory) atrioventricular conduction pathway. This extra pathway bypasses the normal conduction delay of the AV node, which may cause a form of "supraventricular tachycardia" -- a rapid heart rate initiated above the ventricles.
The type of supraventricular tachycardia experienced by people with Wolff-Parkinson-White syndrome is called "re-entry." The location of the extra-electrical pathway in Wolff-Parkinson-White can often be precisely identified.
Wolff-Parkinson-White occurs in approximately 4 out of 100,000 people, and is one of the most common causes of fast heart rate disorders (tachyarrhymthmias) in infants and children.
The frequency of the episodes of rapid heart rate varies from person to person. Patients with Wolff-Parkinson-White may have isolated episodes of rapid heart rate, frequent episodes (occurring once or twice a week), or they may never have symptoms. In the latter case, the condition is often discovered accidentally when a physician is reviewing an ECG requested for some other purpose.
The goal of treatment is to reduce symptoms by reducing the episodes of tachycardia (rapid heart rate).
Medication may be used to control or prevent rapid heart beating. These include adenosine, antiarrhythmics, and amiodarone. Digoxin, verapamil, and beta-blockers (other drugs commonly used to treat other types of tachycardia) can increase the frequency of tachycardia episodes for some people with Wolff-Parkinson-White.
Other treatments to stop a persistent episode of tachycardia may include electrical cardioversion (shock) or catheter ablation with a special type of energy called radiofrequency. This destroys the accessory pathway using a catheter (tube) inserted into the body to reach the heart.
Surgery may provide a permanent cure for Wolff-Parkinson-White. This involves ablation (destruction) of the accessory pathway using open heart surgery. Surgery may be a good approach to cure symptomatic Wolff-Parkinson-White syndrome, but it is usually only done if the patient must undergo surgery for other reasons.
