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Treatments and drugs
By Mayo Clinic staff
The treatment goals for Wolff-Parkinson-White syndrome are to slow a fast heart rate when it occurs and prevent future episodes.
Stopping a fast heart rate
A fast heartbeat may correct itself, and you may be able to slow your heart rate using simple physical movements. However, you may need medication or other medical treatment to slow down your heartbeat. Ways to slow your heartbeat include:
- Vagal maneuvers. Your doctor will ask you to perform an action called a vagal maneuver during an episode of a fast heartbeat. Vagal maneuvers affect the vagus nerve, which helps regulate your heartbeat. The maneuvers include coughing, bearing down as if you are having a bowel movement, and putting an ice pack on your face.
- Medications. If vagal maneuvers don't stop the fast heartbeat, you may need an injection of an anti-arrhythmic medication, such as adenosine, to restore a normal heart rate. An injection of this drug is administered at a hospital. Your doctor may also prescribe a pill version of an anti-arrhythmic drug, such as flecainide (Tambocor) or propafenone (Rythmol, Rythmol SR), to take if you have an episode of a fast heartbeat that doesn't respond to vagal maneuvers.
- Cardioversion. In this procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and restores a normal rhythm. It's typically used when maneuvers and medications aren't effective.
Preventing episodes of a fast heart rate
With the following treatments, it's possible to correct or manage problems related to Wolff-Parkinson-White syndrome in the majority of cases.
- Radiofrequency catheter ablation. This procedure is the most common treatment for Wolff-Parkinson-White syndrome. In this procedure, catheters are threaded through the blood vessels to your heart. Electrodes at the catheter tips are heated to damage (ablate) the extra electrical pathway and prevent it from sending electrical signals. This procedure is highly effective, and complications — which can include heart injury or infection — are uncommon.
- Medications. Anti-arrhythmic medications such as flecainide or propafenone may prevent a fast heart rate when taken regularly. Medications are usually given to people who can't undergo radiofrequency catheter ablation for some reason or don't want to have the procedure.
- Surgery. The success rate for surgical destruction (ablation) of the extra pathway using open-heart surgery is almost 100 percent. However, because radiofrequency catheter ablation is almost as effective and less invasive, surgery for Wolff-Parkinson-White syndrome is now rare. It's typically reserved for people who are having heart surgery for other reasons.
If you don't have symptoms
If you have the Wolff-Parkinson-White pathway but don't have any symptoms, you probably won't need treatment. In some people without symptoms, the extra pathway may spontaneously disappear over time.
Your doctor may be able to evaluate your risk of having episodes of a fast heartbeat based on findings from an ECG or electrophysiological testing. If he or she determines that you may be at risk of an event, your doctor may suggest radiofrequency catheter ablation.
- Early TJ, et al. Wolff-Parkinson-White Syndrome. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?sid=1087785533&eid=4-u1.0-B978-0-323-05610-6..00032-9--sc29000&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00032-9--sc29000&uniqId=227936882-3. Accessed Nov. 24, 2010.
- Wolff-Parkinson-White Syndrome. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4785. Accessed Nov. 24, 2010.
- Arnsdorf MF, et al. Epidemiology of the Wolff-Parkinson-White syndrome. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
- Wolff-Parkinson-White (WPW) Syndrome. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merckmanuals.com/home/sec03/ch027/ch027e.html. Accessed Nov. 24, 2010.
- Wolff-Parkinson-White Syndrome. Genetics Home Reference. http://ghr.nlm.nih.gov/condition/wolff-parkinson-white-syndrome. Accessed Nov. 24, 2010.
- Podrid PJ. Pharmacologic therapy of arrhythmias associated with the Wolff-Parkinson-White syndrome. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
- Knight BP. Nonpharmacologic therapy of arrhythmias associated with the Wolff-Parkinson-White syndrome. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
- Prevention & treatment of arrhythmia. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Prevention-Treatment-of-Arrhythmia_UCM_002026_Article.jsp. Accessed Nov. 24, 2010.
- Symptoms, diagnosis & monitoring of arrhythmia. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/SymptomsDiagnosisMonitoringofArrhythmia/Symptoms-Diagnosis-Monitoring-of-Arrhythmia_UCM_002025_Article.jsp. Accessed Nov. 24, 2010.
- Shen W-K (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 14, 2010.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 12, 2010.
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