WPW - Wolff-Parkinson White Syndrome

WPW - Wolff-Parkinson-White Syndrome Male1: That condition called Wolff-Parkinson-White Syndrome, what does that mean? Male2: Wolff-Parkinson-White Syndrome also known as WPW is a condition in which there is an extra electrical pathway within the heart. It is fairly common, probably occurs in maybe 1% of the population has this extra pathway and this extra pathway can set you up for an extremely rapid heartbeat. Generally it is a very uncomfortable situation and can cause a patient to loose consciousness. It is a rare cause of sudden death in children. Male1: If you have a kid who is getting a rapid heart beat frequently would it be an indication that you have concerned and maybe something like this? Male2: Sure, definitely. This condition as I said set you up for an extremely rapid heartbeat. So someone who comes in with a complaint that there heart is rising, this condition can be quickly ruled out with an EKG. Male1: But if you did an EKG on a kid that had a history of Wolff-Parkinson-White, sometime you do an EKG you can see it? Male2: Well, technically speaking, if you have Wolff-Parkinson-White syndrome then you really should have the particular finding known as the delta wave on the EKG. Male1: Is it always there or sometimes only? Male2: No, it is not always there. Sometimes there are patients who have conceal pathways or have what we call intermittent pre excitation meaning that sometimes on the EKG you have that pathway evident and sometimes you do not. The one good thing is if you are one of those patients where the pathway is intermittently seen, you have the less likely to have a sudden cardiac death. You can still have an extremely rapid heart beat but those patients are generally considered less at risk for certain cardiac death but still need to be treated or their underlying arrhythmia. Male1: If you have Wolff-Parkinson-White, there is a concern. So is there any treatment for it? Male2: Well fortunately with Wolff-Parkinson-White syndrome can be treated and in fact can be cured. Often patients would put on medications for this which would slow the heart rate to try to prevent a rapid heart beat form occurring. However, now, over the last 15 years there is a procedure known as cardiac ablation where an Electrophysiologist, they are a particular type of Cardiologist with expertise in the area of arrhythmia enters the heart with a catheter through the blood vessels in the leg and once inside the heart locate this extra pathway and either burn it or freeze it thereby eliminating the potential for a rapid heart beat. Male1: If you have Wolff-Parkinson-White and the kid have got a medicine like Reglan, is there a risk with the combination together? Male2: That is a great question? I do not think anybody knows the answer to that specifically. Probably what most people would say since the Wolff-Parkinson-White is treatable; I would probably recommend the treating the WPW, the pathway, the cardiac condition first eliminating that and then starting the patient--- Male1: What seems should be a consensus for most of the PH—it should be if you it is there and you have something that could trigger of a decreased heart rate, it makes a lot of sense to control the problem and it is really like a short circuit of the heart in the way it works. Male2: It is. The heart has an electrical conduction system, so called the invisible wires and with Wolff-Parkinson-White, there is an extra wire and extra pathway and that sets up this short circuit loop where the heart beats out of control, heart rate is over 200 beats per minute.