Drs. Wolff, Parkinson, and White fully described the Wolff-Parkinson-White (WPW) Syndrome 1930. There were prior descriptions of the essentials components even before then (Scheinman, 2005).
In this syndrome an extra electrical pathway between the atrium and ventricles is present at birth. This accessory pathway is able to conduct faster than the AV node. Electrically active muscle fibers bridge the atria and ventricles and cause pre-excitation of the ventricles. Paroxysmal Supraventricular Tachycardia (PSVT) is the most common arrhythmia associated with WPW syndrome.
According to the Mayo Clinic staff, an abnormal gene is the cause in a small percentage of people with WPW. The syndrome also is associated with some forms of congenital heart disease, but little is known about how the extra pathway develops.
It is a fairly rare occurrence and generally not life-threatening, although some deaths have been reported. This syndrome is frequently discovered by accident during a heart exam with an ECG, since generally there is no increased fast heartbeat.
According to Cain et al., (2013) from their study of 243 children with WPW syndrome of those who presented at ≤3 months of age, 35% had resolution of manifest preexcitation compared with 5.8% who presented at >3 months of age (p <0.0001). There were 6 sudden deaths (1.3%), with an incidence of 2.8 per 1,000 patient-years.
Two of the deaths occurred in patients with structurally normal hearts, and four had associated heart disease.Two of these patients had structurally normal hearts (incidence 1.1 per 1,000 patient-years). Four of these patients had associated heart disease (incidence 27 per 1,000 patient-years) (p <0.01).
WPW Can be difficult to diagnose in some children because of high incidences of normal sinus rates.
EKG characteristics are seen only after a rhythm conversion from PSVT to NSR; see a representative tracing.
Signs and symptoms in infants with WPW syndrome can include:
In the case of serious heart problems developing, with fast heart rates, ablation of the extra pathway can permanently correct the increase in heart rate.
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An abnormal gene is the cause in 50% of people with WPW.
References
Cain, N., Irving, C., Webber, S., Beerman, L. & Arora, G. (2013). Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood. Am J Cardiol. 112(7), 961-5.
Mayo Clinic Staff. (2021) Wolff-Parkinson-White (WPW) Syndrome. https://www.mayoclinic.org/diseases-conditions/wolff-parkinson-white-syndrome/symptoms-causes/syc-20354626.
Scheinman, M.M. (2005). History of Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 28(2), 152-6. doi: 10.1111/j.1540-8159.2005.09461.x. PMID: 15679646.