Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White (WPW) is when the heart has an extra electrical pathway, also called an accessory pathway. Because of this extra pathway, electrical signals in the heart avoid the normal electrical pathway. This can lead to life-threatening heart rhythm problems.

In WPW, children are usually born with the extra pathway. About 10% to 20% of infants with WPW also have congenital heart disease, in particular Ebstein’s anomaly.

• How does a normal heartbeat happen?

  The heart has 4 chambers (spaces that hold blood): 2 atria at the top and 2 ventricles at the bottom. A complex electrical system makes these chambers squeeze and relax, at the right time and in the right order, to pump blood.

  A heartbeat starts in the right atrium when a group of cells (sinus node) sends an electrical signal. The signal travels through the atria, making their muscle walls squeeze. Then the signal moves into the area between the atria and ventricles. This area is the atrioventricular node (AV node).

  The AV node slows the signal slightly and then passes it on to the ventricles, making them squeeze. After the ventricles squeeze, the heartbeat cycle is complete.

• What is different in Wolff-Parkinson-White syndrome?

  In WPW, electrical signals in the heart do not travel along the normal route because of the extra (accessory) pathway. This may lead to 2 kinds of heart rhythm problems: 

  • Supraventricular tachycardia (SVT). Tachycardia (pronounced tack-ih-CARD-ee-ah) means the heart is beating too fast. Children with SVT may need treatment with medicines, radiofrequency ablation or cryoablation. SVT is not usually life threatening.
  • Atrial fibrillation leading to ventricular fibrillation. Fibrillation (pronounced fib-rill-AY-shun) means very fast, irregular twitching of a muscle. Atrial fibrillation is rare in children.
    • When it happens to someone without WPW, the normal route of electricity in the heart slows down signals from the atria to the ventricles. This limits how quickly the ventricles beat.
    • When it happens to someone with WPW, the extra pathway can send signals too fast from the atria to the ventricles. This can cause ventricular fibrillation, which is life threatening. This heart rhythm problem may need to be reset using a defibrillator. 

• The experts you need are here
  • Seattle Children’s team of 40+ pediatric cardiologists diagnoses and treats WPW in children of all ages, from newborns to adolescents.
  • Our Arrhythmia Program includes 3 full-time pediatric electrophysiologists, more than anywhere else in the region. After their training in pediatric cardiology, they have further subspecialty training in dealing with cardiac arrhythmias. The Arrhythmia Program is also supported by a team of specialty technicians and nurses who know how to deal with these conditions.
  • We offer a full range of diagnostic procedures and treatments. Along with using heart medicines, we have deep experience with radiofrequency ablation and cryoablation procedures in children who need them to correct an abnormal heart rhythm.
• Among the nation’s top programs

   

  • See our statistics and outcomes.
• Care from before birth through young adulthood
  • If your developing baby is diagnosed with supraventricular tachycardia before birth, our Fetal Care and Treatment Center team works closely with you and your family to plan and prepare for the care your baby will need.
  • Your child’s treatment plan is custom-made for them. Some children with WPW do not need treatment, and others do. We closely watch your child’s needs to make sure they get the care that is right for them at every age.
  • If your child was born with WPW, we have a special Adult Congenital Heart Disease Program to meet your child’s long-term healthcare needs. This program, shared with the University of Washington, transitions your child to adult care when they are ready.
• Support for your whole family
  • We are committed to your child’s overall health and well-being and to helping your child live a full and active life.
  • Whatever types of care your child needs, we will help your family through this experience. We will discuss your child’s condition and treatment options in ways you understand and involve you in every decision.
  • Our nurses are experienced at supporting families with WPW. They help manage your child’s care and teach you and your child about this condition.
  • Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
  • Seattle Children’s has many resources, from financial to spiritual, to support your child and your family and make the journey as smooth as possible. We regularly see families who travel from other states and countries to come to our Arrhythmia Program.
  • Read more about the supportive care we offer.
• Advancing pediatric care
  • Doctors at Seattle Children’s are working to advance treatment for WPW and enhance the quality of life for children with this condition.
  • We were the first institution in the region to routinely offer cryoablation for children, greatly increasing the safety of ablation for arrhythmia.
  • Seattle Children’s is one of the few institutions in the region to offer “zero fluoro” or “minimal fluoro” ablation. This means we use techniques – many that we developed – to expose your child to little or no X-ray radiation. Most places use fluoroscopy during ablation.
  • Stephen Seslar has been part of creating databases to track ablation procedures and outcomes. He has used the data to help identify risk factors for sudden death in children with WPW.
  • Jack Salerno has worked with organizations, like the Nick of Time Foundation, to help identify young people who might have WPW or other arrhythmia conditions before they develop a problem.
  • Terrence Chun has a special interest in improving methods to detect conditions like WPW and improving the safety and accuracy of ablation procedures to cure this condition.