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Wolff-Parkinson-White Syndrome

Overview

Wolff-Parkinson-White syndrome (WPW) is a condition of the heart where the heart beat doesn’t follow the set pattern. Wolff-Parkinson-White syndrome is characterised by attacks of rapid heart rate (tachycardia), which is shown in an electrocardiogram (ECG). In some people the ECG abnormality may be present without any symptoms such as tachycardia. While, in a normal healthy heart, the electrical signals use only one path when they move through the heart, from the heart’s upper chamber (the atria), to the lower chambers (the ventricles), causing the heart to beat. For the heart to beat properly the timing of the electrical signal is important. Whereas, in the case of (WPW), there is an extra conduction pathway, where the electrical signals passed may arrive at the ventricles (lower chambers of the heart) too soon. This condition is called Wolff Parkinson White Syndrome and falls in the category of abnormalities called ‘Pre-excitation syndromes.’  


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Causes

The cause for Wolff-Parkinson-White syndrome is unknown but it is one of the leading causes of fast heart rate disorder in newborns and young children. It is not clear what causes the additional pathway to develop inside the heart. 
The condition is present at birth, but genetic factors usually do not play a major role. However some families may have more than one affected individual and there does appear to be a weak hereditary tendency, with an increased incidence in the children of affected individuals (4-5 per 1000). Since the cause is unknown, prevention is not possible. Some of the Risks involved with this disease are low blood pressure, loss of consciousness, heart failure and heart attack and in extreme cases- sudden death.


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Signs & Symptoms

The symptoms of Wolff-Parkinson-White syndrome include periods of accelerated or rapid heart rate, in most cases usually faster than 200 beats per minute. The person may also suffer from Heart Palpitations, feel an uneasy tightness in the chest, be short of breath at times. Another symptom for WPW is a sudden drop in blood pressure and a feeling of light-headedness. Some patients may also show symptoms of dizziness and have fainting spells.

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Prevention

Since the root cause of WPW is not ascertained and may be present from birth itself, total prevention is not possible. Also, in the case of some children this problem may resolve on its own, usually in the few early years of their life. But, if it persists some methods are prescribed to combat Wolff Parkinsons-White Syndrome, depending on the severity of the disease in the patient.

While these various treatments are the possible cures for the Wolff Parkinsons White Syndrome disease, a person suffering from it will need to have ongoing monitoring and be under supervision with regular ECG’s (electrocardiogram), to make sure their heart is functioning normally.


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Treatments
Artificial Pacemaker Modern Medicine

An artificial pacemaker is also used for this condition to help regulate the heart beat rate.

Electric cardioversion (shock) Modern Medicine

Electric cardioversion (shock) is also used sometimes, to stop a tachycardia attack.

Electro Physiology Study Modern Medicine

An electro physiology study is conducted to locate the site of the extra pathway used to conduct electric signals through heart and eliminate it, using a short treatment with radio frequency energy, applied through a catheter. This method usually cures the disorder and can be done effectively in most patients after the age of seven years. In most cases, the extra path of electric charge in the heart is easily found. But, if the electric charge path cannot be located or eliminated safely then long term medication or surgery may be the recommended prevention technique.

Open-heart Surgery Modern Medicine

An Open-heart surgery may need to be conducted to eliminate the extra pathway of electric signal passing through the heart.

Use of Antiarrhythmic Drugs Modern Medicine

If the above mentioned maneuvers are ineffective, drugs such as verapamil or adenosine are usually given intravenously to stop the arrhythmia. Antiarrhythmic drugs may then be continued regularly to prevent episodes of a fast heart rate. These medicines are to slow the heart rate or to prevent attacks. However, the medications to control the heart rate may not always work for the patient and may sometimes cause side effects. Also, even if the medicine is effective, the prolonged use of the drug such as treatment over many years is not advisable.

 

Vagal Manoeuvres Modern Medicine

Wolff-Parkinson-White syndrome causes episodes of paroxysmal supraventricular tachycardia that can be stopped by one of several maneuvers that stimulate the vagus nerve and thus slow the heart rate. Vagal manoeuvres, which is the use of some tricks that may slow the heart rate down. This trick may happen by blowing hard against resistance (such as with mouth and nose closed) or by using a facial ice pack. These two tricks may help cause a nerve reflex to slow the heart rate down. But, a cardiologist’s advice may be sought to attain the desired result in such situations and otherwise. The maneuvers are most effective when they are used shortly after the arrhythmia starts.

 

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