Wolff–Parkinson–White (WPW) syndrome is a cardiac rhythm disorder caused by the presence of an accessory conduction pathway in the heart. This condition may present with episodes of rapid heartbeat (tachycardia), dizziness, or even loss of consciousness. Treatment of WPW syndrome is aimed at eliminating arrhythmia and preventing potentially serious complications.
Symptoms of WPW syndrome
- Palpitations (paroxysmal tachycardia).
- Dizziness or presyncope.
- Shortness of breath and a sensation of air hunger.
- Chest pain or pressure.
- Loss of consciousness (in severe cases).
Some patients may remain asymptomatic, and WPW syndrome is detected incidentally during an electrocardiogram (ECG).
Causes of WPW syndrome
WPW syndrome is associated with a congenital accessory conduction pathway in the heart, known as the Kent bundle, which disrupts the normal electrical conduction system. The condition is often diagnosed in adolescence or young adulthood, although it may also manifest later in life.
Approaches to the treatment of WPW syndrome in Belarus
Emergency management of tachycardia episodes
During an acute episode of paroxysmal tachycardia associated with WPW syndrome, the following measures may be used:
Vagal maneuvers
Increasing vagal tone to slow the heart rate.
- Gentle ocular pressure (only under medical supervision).
- Cold facial immersion or cold compress.
- Valsalva maneuver (straining).
Antiarrhythmic medications. Used to terminate tachycardia and control heart rate.
Electrical cardioversion. Applied in severe cases when drug therapy is ineffective or the patient’s condition is unstable.
Preventive treatment. The main goal of prevention is elimination of the accessory pathway in order to avoid recurrent tachycardia episodes and serious complications.
Pharmacological therapy. A combination of medications with different mechanisms of action may be used for symptom control and reduction of complication risk.
Radiofrequency catheter ablation (RFA)
RFA is considered the most effective treatment for WPW syndrome.
Advantages:
- High success rate (over 95%).
- Minimal risk of complications.
- Complete elimination of the accessory pathway.
How the procedure is performed:
- Diagnostic evaluation. Prior to ablation, an electrophysiological study (EPS) is performed to precisely localize the accessory pathway.
- Catheter ablation. Through a catheter inserted into the vascular system, radiofrequency energy or cryoenergy is delivered to destroy the abnormal conduction tissue.
- Recovery. The patient is monitored for 1–2 days and usually returns to normal daily activities within a few days.
Prevention of complications and long-term follow-up
- Regular follow-up examinations. ECG and Holter monitoring are used to assess heart rhythm.
- Avoidance of triggering factors. Stress, excessive physical exertion, and stimulants such as caffeine and alcohol.
- Prevention of sudden cardiac death. Especially important in patients with documented episodes of ventricular fibrillation.
Treatment of WPW syndrome depends on symptom severity and the frequency of tachycardia episodes. Definitive elimination of the accessory pathway using radiofrequency catheter ablation is the most effective and safe method, allowing patients to return to a full and active life. Regular cardiology follow-up and adherence to medical recommendations help minimize complications and ensure long-term rhythm stability.
