Wolff-Parkinson-White syndrome may be associated with congenital heart diseases in some cases. While some of them are good, some of them can cause serious problems. In cases with congenital heart disease, the frequency of symptoms increases.

Wolff-Parkinson-White syndrome (WPW)

It is a congenital disease characterized by symptoms that develop due to a disorder in the conduction system of the heart. It is part of a group of diseases called Preexcitation Syndrome and is the most famous of the group. There are additional conduction pathways to the congenitally normal cardiac conduction system.

Since Wolff-Parkinson-White syndrome is a congenital disease, it is mostly diagnosed in childhood or adolescence. It is more common in men. Its incidence in the population is about one in 100 thousand.

The disease usually has a good prognosis. Most patients do not have any symptoms. It occurs in an ECG analysis performed for another reason. Some of the patients may have symptoms such as palpitation, sweating and fainting.

Wolff-Parkinson-White syndrome may be associated with congenital heart diseases in some cases. While some of them are good, some of them can cause serious problems. In cases with congenital heart disease, the frequency of symptoms increases.



Congenital heart diseases that may be associated with Wolff-Parkinson-White syndrome include:

  • Mitral valve prolapse: The valve located between the left chambers (mitral valve) is loose. Some blood flows back from the upper left chamber to the lower chamber. It’s usually good looking. It is common.
  • Cardiomyopathy: It is a generally severe congenital heart disease characterized by congenital enlargement of the heart muscles, narrowing and hardening of the chambers.
  • Ebstein Anomaly: The valve (tricuspid valve) located between the chambers on the right side is located downwards. The insufficiency progresses in the form of backward blood leakage. It is rare normal conduction system of the heart

The heart has a conduction system that stimulates the muscles and initiates contraction, continuing without a hitch. This messaging system basically consists of two nodes and message paths.

  • Sinoatrial node: It is located at the back of the upper chamber (right atrium) of the heart, where the vein (vena cava) that brings the dirty blood from the body to the heart opens into the chamber. It generates about 90 alerts (80-100) per minute.
  • Atrioventricular node: It is located at the base of the chamber (right atrium) above the heart, close to the right lower chamber (right ventricle) and valve (tricuspid valve). By keeping the stimulus coming from the sinoatrial node waiting for a while, it ensures the order by allowing the upper chambers to contract first and then the lower chambers to contract. It can send up to 40-60 messages per minute.
  • Bundle of His: It is the muscular system that carries the message from the atrioventricular node located at the base of the right upper chamber (right atrium) to the lower chambers (right and left ventricle). It carries 15-40 messages per minute.
  • Purkinje cells: These are the fibers that carry the message from the His bundle to all parts of the right and left lower chambers (right and left ventricle). It carries 15-40 messages per minute.

In the heart, stimulation begins first in the sinoatrial node. It circulates through the right and left atria and comes to the atrioventricular node. Here, the speed slows down a little, it is kept a little bit. From here, it is transmitted to the right and left ventricles by the bundle of His and Purkinje cells. The message is an electrical impulse and causes the heart muscles to contract. In this way, the blood first fills the right upper chamber, from there it is distributed to the lower right chamber, the lung, the lower left chamber, the upper left chamber, and from there to the whole body.

How is the cardiac conduction system affected in Wolff-Parkinson-White syndrome?

In Wolff-Parkinson-White syndrome, there are conduction pathways that are absent in a normal cardiac conduction system. These congenital accessory pathways transmit the conduction that starts in the sinoatrial node directly to the ventricles, without passing through the atrioventricular node, which it should normally visit. Therefore, the rate of conduction, which is normally slowed in the atrioventricular node, cannot be controlled. The heart rate increases. Tachycardia and rhythm disturbances develop.



Accessory pathways may not always work to an indicative extent. It may show symptoms in some periods. Sometimes, the accessory path either stays silent, does not send a message, or closes on its own, and the disease disappears completely. However, it can rarely cause life-threatening rhythm disorders.

Symptoms of Wolff-Parkinson-White syndrome

Wolff-Parkinson-White syndrome is generally a benign picture. Most patients do not show any symptoms. Although the disease is congenital, symptoms may not appear until adolescence. Some cases present with mild palpitations. Very rarely, it can cause serious rhythm disturbances.

Symptoms may come in the form of seizures. The frequency of seizures varies from person to person. Some may have complaints once a year, while others may have complaints every day.

Possible symptoms could be:

  • Palpitations (supraventricular tachycardia),
  • Dizziness,
  • Weakness, fatigue,
  • Fainting,
  • Respiratory distress,
  • Chest pain.

Diagnosis of Wolff-Parkinson-White syndrome

Since Wolff-Parkinson-White syndrome does not usually show any symptoms, it is detected during routine controls in patients who apply to a physician for other reasons.

The most prominent finding in symptomatic patients is an increase in heart rate bouts of seizures.


Tags: