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cardiovascular|palpitations|shortness of breath|syndrome

Wolff-Parkinson-White Syndrome

Last Updated June 2023 | This article was created by editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

What is Wolff-Parkinson-White syndrome?

Wolff-Parkinson-White (WPW) syndrome is a heart condition. People who have WPW syndrome are born with an extra electrical pathway in their heart. It changes the rhythm of their heartbeat. That’s called an arrhythmia. They may experience a very fast heartbeat (called tachycardia) for periods of time. Symptoms can start without warning. However, certain things may trigger them, including caffeine, alcohol, and stimulants. The condition is rare and affects all ages, including infants.

Symptoms of Wolff-Parkinson-White syndrome

Some people who have WPW syndrome never experience any symptoms. They don’t know they have the condition. Most people don’t notice symptoms until they are in their teens or early twenties. That’s when the symptoms commonly appear for the first time. If you have WPW syndrome, you may experience:

  • Unexplained anxiety
  • Palpitations (rapid thumping or fluttering) in the chest
  • Feeling tired (fatigue)
  • Feeling light-headed or dizzy
  • Loss of consciousness (passing out)
  • Shortness of breath
  • Chest pain

Infants may experience a change of color on their skin (pale gray), irritability, rapid breathing, and loss of appetite.

An episode of rapid heartbeat can last a few seconds to a few hours.

What causes Wolff-Parkinson-White syndrome?

The exact cause of WPW is unknown. However, in a small percentage of people, it is tied to an abnormal gene.

How is Wolff-Parkinson-White syndrome diagnosed?

See your doctor if you are experiencing an unusual heartbeat. Your doctor will listen to your heart by placing a stethoscope over your chest. Additional tests to check for the disorder include an electrocardiogram (ECG or EKG). During this test, a medical technician or assistant will attach sticky pads to your chest (electrodes). These are connected to a machine that records your heart’s electrical activity.

Further testing may include walking on a treadmill in your doctor’s office. You will be connected to an EKG machine that monitors your heart’s electrical activity while you walk. Your doctor also may want to monitor your heart while you do your daily activities. For that, your doctor may give you a heart monitor to take home and wear during a normal day of activity. The monitor is attached to an elastic band that fits around your chest.  It continuously records your heart’s rhythms for 24 hours. If your doctor wants to monitor your heart for more than 24 hours, your doctor might recommend an event-recorder. That is a machine that records samples of your heart’s rhythms. It can be worn for a couple of days or longer and allows you to notate or alert the system when you are having symptoms.

Another test, called electrophysiologic studies, may also give your doctor information about your heart. This test is more complex. You will be asleep during the test. You will be given an IV (intravenous line) in the vein in your arm with medicine that makes you relaxed and sleepy. Once you are asleep, your doctor will insert a small tube into your artery or vein. They will send small electric pulses through the tube to make your heartbeat at different speeds. The test will map how your heart reacts to locate specific problems. The test could last up to 4 hours.

Can Wolff-Parkinson-White syndrome be prevented or avoided?

Since you are born with the disorder, there is nothing you can do to prevent or avoid it. However, if you know that certain triggers, such as caffeine, stimulants, or alcohol, change your heart rate, you should avoid those things.

Wolff-Parkinson-White syndrome treatment

There are several treatment options available for WPW syndrome. You doctor may talk to you about vagal maneuvers. These are things you can do on your own to help slow your heart rate. These things include coughing or pushing down like you are having a bowel movement. If vagal maneuvers don’t help slow your heart rate, your doctor may prescribe an anti-arrhythmic medicine.

Sometimes, people must have their heart electrically shocked to bring the heartbeat back to normal. Your doctor will hold paddles against your chest for this procedure. For some people, surgery may also be an option.

Living with Wolff-Parkinson-White syndrome

It is possible for WPW symptoms to disappear over time. For those who continue to experience symptoms, living with WPW can be frustrating. Unless you know your trigger, you can’t anticipate when your heartbeat will become rapid. And you don’t know how long it will stay that way. Having to have your heart shocked back to a normal beat can be stressful.

Questions to ask your doctor

  • Will the medicine I take for WPW interact with other medicines I take?
  • Can WPW cause death?
  • Can I pass WPW onto my children?
  • Is it safe for me to exercise?
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