Treatment of Wolff-Parkinson-White Syndrom (WPW-syndrom)
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University Hospital Ulm
Department of Cardiology, Angiology and Internal Intensive Care
Charite University Hospital Berlin
Department of Cardiology and Angiology
University Hospital Heidelberg
Department of Cardiology, Angiology and Pulmonology
University Hospital RWTH Aachen
Department of Cardiology, Pulmonology and Angiology
University Hospital Frankfurt am Main
Department of Cardiology and Angiology
University Hospital Jena
Department of Cardiology, Angiology, Pulmonology and Intensive Care
University Hospital Erlangen
Department of Cardiology and Angiology
University Hospital Würzburg
Department of Cardiology, Endocrinology, Nephrology and Pulmonology
University Hospital of Ludwig Maximilian University of Munich
Department of Cardiology
University Hospital Duesseldorf
Department of Cardiology, Pulmonology and Angiology
University Hospital Halle (Saale)
Department of Cardiology, Angiology and Internal Intensive Care
University Hospital Marburg UKGM
Department of Cardiology, Angiology and Internal Intensive Care
University Hospital Rechts der Isar Munich
Department of Cardiology, Angiology and Pulmonology
University Hospital Bonn
Department of Cardiology, Angiology and Pulmonology
University Hospital Muenster
Department of Cardiology
Wolff-Parkinson-White syndrome is the heart disease, during which the heart experiences the electrical disorder. It is more commonly known as the syndrome of WPW. Wolff-Parkinson-White syndrome is a rare disease with only 0.2-0.3% of population being born with it. It means that out of 100 000 people there are at least 3 of them with the mysterious WPW. To understand better what the Wolff-Parkinson-White syndrome actually means, the person needs to know that human heart has upper and lower chambers. To be more specific, there are 2 upper chambers and 2 lower ones. If there is an additional electrical pathway between these two chambers, the person experiences a very rapid heartbeat, which can also be called tachycardia. During the tachycardia, the heart makes about 100-150 beats per minute which is abnormal. Usually the person with normal heart rhythm has the average of 70-80 beats per minute. Although people are born with Wolff-Parkinson-White syndrome, they do not experience its side effects until they are at least 11. Sometimes this syndrome goes by unnoticed until the person is 50. During his lifetime a patient can feel the rapid pulse or have early forms of anemia, but overall the disease does not bother him. The good news is that nobody dies from Wolff-Parkinson-White syndrome, so it's not a terminal disease and it can be cured. Nevertheless, it can cause other heart diseases, so it's important to undergo the usual Wolff-Parkinson-White syndrome treatment.
As it was mentioned above, the rapid heartbeat is the most common Wolff-Parkinson-White syndrome symptom, although there are other side effects. They include:
- The feeling of heaviness in the heart
- Anxiety attacks over nothing
- Dizziness
- Nausea
Other WPW symptoms are as follows:
- Unusual pain in the chest
- Tightness around the heart
- Breathing becomes more slow and rugged and the person feels like he is in the mountains
The acceleration of the heartbeat can occur in any minute given, but there are some cases when Wolff-Parkinson-White syndrome shows itself the most. The person may feel sudden loud heart beats, that can even be echoed in the ears after some minor exercise or after he had a cup of coffee. Such episodes may also happen during smoking or during walking. Sometimes the person wakes up during the night because of the heartbeat and very often he feels anxiety, because he can not simply understand why his heartbeat speeds up all the time. At that stage of Wolff-Parkinson-White syndrome most people usually go to the psychologist, thinking that the rapid heartbeat is the reaction of their organism to some stressful situations in personal or professional life. The biggest mistake is that most people forget to notice that the heart is the only indicator of their anxiety and they neglect the visit to cardiologist. It may be very dangerous in the bigger run.
Another problem is that WPW has the same symptoms as another heart disease – the atrial fibrillation. Usually only the experienced cardiologist can differentiate these two diseases for sure. The atrial fibrillation has more serious consequences than Wolff-Parkinson-White syndrome, which most often may be absolutely harmless. The only real complication is that people with syndrome of Wolff-Parkinson-White can not become sportsmen or engage in any high-intensity sport activity.
The first thing the doctor does is thorough examination of the medical history to see if a patient has any tendency for the heart diseases. After that a patient undergoes usual blood test. Sometimes there is a special hormone in the blood that accelerates the heartbeat and this is the reason of tachycardia. In that case the patient takes some hormonal medicines. If the reason is different, he undergoes the X-ray of the chest. This type of X-ray is necessary to perform if the heart is somewhat enlarged. If it so, its volume causes the tension and pain in the chest. If the enlarged heart is still not the case, the electrocardiogram is performed. An electrocardiogram can record all kinds of electrical signals that the heart receives and sends. If there is even a slight alteration in the usual exchange of electrical signals, this is a final indicator of Wolff-Parkinson-White syndrome.
If the person does not have any symptoms and has been diagnosed with WPW accidentally, during the usual check-up, he does not really need any treatment. If the accelerated heartbeat does not stop, treatment includes the following options:
- Intake of of antiarrhythmic drugs and drugs that slow down the heartbeat. This does not eliminate the causes of WPW, but significantly alleviates symptoms.
- Closed catheter ablation, when the catheter is practically threaded through the tissues to the heart. During the catheter ablation the person’s extra electrical pathways, that were the main reason for the WPW, are heated and therefore destroyed. This is the most effective treatment for WPW syndrome with almost 90% of patients recovering after the procedure. There is also option of the open invasive catheter ablation, which is performed during open heart surgery. It also shows good results.
- Cardioversion. Although cardioversion may seem an extreme measure, it demonstrates impressive results. During the cardioversion a doctor shocks the patient's heart with special electrodes and makes the heart rhythm normal again. Cardioversion may be used if the drugs that normalize the heart rhythm do not work anymore. It happens because the heart gets used to them and stops to respond. Moreover, the drugs may wear down the heart a bit, so it's more advisable to undergo the cardioversion to have the normal heartbeat for long years after the procedure.
- Vagal manoeuvres are a type of physical therapy when the person closes his nose and exhales with his mouth. After that he tries not to breathe as long as possible and then makes a long inhale. It stimulates the vagus nerve, which reduces heart rate.
- In addition, patients with Wolff-Parkinson-White are advised to take lessons of yoga and pilates to normalize their heartbeat and to bring harmony into their bodies. Some also go to the seaside because it is believed that the sea air improves the respiratory system of the person, thus preventing strokes and unwanted dizziness. In fact swimming, which is considered to be a not high-intensity sport, may be a good solution for people who have WPW, but still want to work out regularly without heart complications.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed