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Heart rhythm conditions

Wolff-Parkinson-White syndrome

WPW is an extra electrical connection in the heart. It may cause episodes of a fast heartbeat, but some people have no symptoms at all.

Introduction

Wolff-Parkinson-White (WPW) syndrome occurs when there is an additional electrical pathway between the upper and lower chambers of the heart. In some people this can create a circuit that triggers a rapid rhythm. It is usually present from birth, although it may only be recognised later in life.

An ECG can show a WPW pattern even in someone who has never had a fast rhythm. The distinction matters: a pattern on an ECG does not automatically mean that treatment is needed. The assessment considers symptoms, the ECG, occupation, activity and the features of the extra pathway.

Assessment and treatment

If someone experiences palpitations, a monitor may help capture the rhythm during an episode. An electrophysiology study can sometimes clarify how the pathway behaves. Decisions are individual: observation may be appropriate for some people, while medication or catheter ablation may be discussed for recurrent symptoms or particular risk features.

Catheter ablation treats the extra pathway directly. It is a planned procedure with specific benefits and risks that should be discussed in relation to your own situation.

Key points

  • WPW can cause sudden episodes of a fast heartbeat, but many people have few or no symptoms.
  • An ECG and the story of your symptoms are central to assessing the condition.
  • Treatment is not automatic; it is based on symptoms, risk assessment and your preferences.

Patient note

“The important question is not simply whether an extra pathway is present, but what it means for you and whether it needs to be treated.”

Questions about Wolff-Parkinson-White syndrome

Has the fast rhythm been recorded? What does my ECG show? Is observation reasonable, or would an electrophysiology study or ablation provide a clearer long-term plan?

FAQ

Is WPW inherited?

Most cases are not part of a wider inherited rhythm condition, although rare familial forms do occur. A significant family history should always be discussed during assessment.

When should I seek urgent help?

Call 999 if a fast heartbeat does not settle quickly, or occurs with fainting, chest pain, severe breathlessness or feeling seriously unwell.