Question: What is WPW (Wolf-Parkinson-White Syndrome) and how should it be treated?
Answer :Wolf-Parkinson-White Syndrome is a condition that occurs very infrequently. It is something that you're born with that develops in an embryo or a fetus when the heart is forming. Normally, the upper and lower chambers separate from one another completely with just one line of tissue or wire going between the upper and lower chambers to conduct the electrical impulse of the heart.
In Wolf-Parkinson-White Syndrome or WPW, the separation fails and there is a band of tissue that is in parallel to the normal band that should be there. So, you actually have two separate pathways to get from the upper chambers, or atria, to the lower chambers, or ventricle. Because there are two pathways, there's a possibility of creating a short circuit which can allow the development of a loop of electrical activity, causing a very rapid heart rate.
In most people, the rhythm disturbances that occur are annoying but not dangerous. In an occasional person, their danger is particularly when this occurs in conjunction with another rhythm disturbance called atrial fibrillation.
As far as treatment is concerned in the remote pass, say 20 or 30 years ago, we used to treat this with medications. We then went through a short period of time when surgical procedures were developed, in which we did open heart surgery to separate that extra pathway that shouldn't be there.
In more recent years, we've developed a technique called ablation in which we can go in with a catheter, deliver energy to the site where that extra pathway is and burn it out of there. And that takes you back to where you should be -- namely a single pathway between the upper and lower chambers of the heart.
In many patients, this option is elective. It's a question of how much they're troubled by the heart rhythm disturbances, if they have them at all. But in patients with atrial fibrillation, because this creates a real life-threatening danger, this procedure is virtually recommended in all people.