From the Guidelines
Wolf Parkinson White syndrome is a heart condition characterized by an extra electrical pathway between the heart's upper and lower chambers, causing rapid heartbeat episodes, and the most effective treatment is catheter ablation, which has a success rate of over 90%. Symptoms of WPW syndrome include palpitations, chest pain, shortness of breath, dizziness, fainting, and in rare cases, sudden cardiac death 1. Some patients may remain asymptomatic until an episode occurs.
Treatment Options
The treatment options for WPW syndrome include:
- Medication: Medications like adenosine, beta-blockers (such as metoprolol 25-100mg twice daily), calcium channel blockers (like verapamil 120-360mg daily), or anti-arrhythmic drugs (such as flecainide 50-200mg twice daily) can control symptoms temporarily 1.
- Catheter ablation: This is the definitive treatment, with a success rate of over 90% 1. During this minimally invasive procedure, the abnormal pathway is destroyed using radiofrequency energy or cryotherapy.
- Surgery: This is rarely used to treat WPW syndrome.
Recommendations
Catheter ablation is recommended in symptomatic patients with pre-excited AF, especially if the accessory pathway has a short refractory period that allows rapid antegrade conduction 1. Patients should seek immediate medical attention during episodes of rapid heartbeat, especially if accompanied by severe symptoms. The condition results from a congenital abnormality where the accessory pathway (Bundle of Kent) bypasses the heart's normal electrical conduction system, allowing electrical signals to travel in both directions and creating a circuit that causes rapid heartbeats.
Key Points
- WPW syndrome is a heart condition characterized by an extra electrical pathway between the heart's upper and lower chambers.
- Symptoms include palpitations, chest pain, shortness of breath, dizziness, fainting, and in rare cases, sudden cardiac death.
- Catheter ablation is the definitive treatment, with a success rate of over 90%.
- Patients should seek immediate medical attention during episodes of rapid heartbeat, especially if accompanied by severe symptoms.
From the FDA Drug Label
In patients with Wolff-Parkinson-White (WPW) syndrome, propafenone reduces conduction and increases the effective refractory period of the accessory pathway in both directions The symptoms of Wolf Parkinson White (WPW) syndrome are not directly stated in the provided drug labels. However, the treatment option for WPW syndrome using propafenone is mentioned, which reduces conduction and increases the effective refractory period of the accessory pathway in both directions 2. Key points about propafenone treatment for WPW syndrome:
- Reduces conduction of the accessory pathway
- Increases the effective refractory period of the accessory pathway
- Slows conduction and produces dose-related changes in the PR interval and QRS duration 2
From the Research
Symptoms of Wolf Parkinson White Syndrome
- Palpitations
- Dizziness
- Shortness of breath
- Presyncope
- Syncope
- Tachycardia
- Hypotension
Treatment Options for WPW Syndrome
- Pharmacological treatment
- Radiofrequency ablation
- Elective cardioversion
- Management may vary from only acknowledging the presence of the accessory pathway to more invasive procedures
Importance of Early Diagnosis and Risk Assessment
The management of WPW syndrome can be challenging, and early diagnosis, risk assessment, and appropriate treatment are critical steps in improving the quality of life and reducing the risk of life-threatening arrhythmias 3, 4. Successful radiofrequency ablation of the accessory pathway can completely prevent further inducible atrial fibrillation 5. It is imperative to detect the WPW electrocardiographic pattern, diagnose WPW syndrome early, and adequately risk stratify those at risk for serious complications 4. Recognizing, managing, and predicting the risk of ventricular fibrillation in patients presenting with pre-excited atrial fibrillation is also crucial 6.