heart and blood vessel disorders
Wolff Parkinson White (WPW) Syndrome
Treatment of WPW Syndrome
Maneuvers and drugs to convert heart rhythm Sometimes ablation Episodes of Paroxysmal Supraventricular Tachycardia (SVT, PSVT) due to Wolff-Parkinson-White syndrome can often be stopped by one of several maneuvers that stimulate the vagus nerve and thus slow the heart rate. Maneuvers include Straining as if having a difficult bowel movement Rubbing the neck just below the angle of the jaw (which stimulates a sensitive area on the carotid artery called the carotid sinus) Plunging the face into a bowl of ice-cold water These maneuvers are most effective when they are used shortly after the arrhythmia starts. When these maneuvers are ineffective, drugs such asverapamil,diltiazem, oradenosineare usually given intravenously to stop the arrhythmia. Antiarrhythmic drugs may then be continued indefinitely to prevent episodes of a fast heart rate (see table). In infants and children younger than 10 years,digoxinmay be given to suppress episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome. However, adults with the syndrome should not takedigoxinbecause it can facilitate conduction by the extra pathway and increase the risk that atrial fibrillation will degenerate into ventricular fibrillation. For this reason,digoxinis usually stopped before people with this syndrome reach puberty. Destruction of the extra conduction pathway by Destroying Abnormal Heart Tissue (Ablation) (delivery of energy using radiowaves, laser pulses, or high-voltage electrical current or freezing with cold through a catheter inserted in the heart) is successful in more than 95% of people. The risk of death during the procedure is less than 1 in 1,000. Ablation is particularly useful for young people who might otherwise have to take antiarrhythmic drugs for a lifetime. 