Causes of Wolff-Parkinson-White (WPW) Syndrome

Introduction

Wolff-Parkinson-White (WPW) syndrome is a congenital condition characterized by the presence of an extra electrical pathway in the heart. This can lead to episodes of tachycardia (rapid heart rate), palpitations, dizziness, or even life-threatening arrhythmias.

Causes of WPW Syndrome

WPW syndrome is primarily caused by an abnormal accessory conduction pathway called the Bundle of Kent. This pathway allows electrical signals to bypass the normal conduction system (the AV node), leading to pre-excitation of the ventricles. Here are the main causes and risk factors:

1. Congenital Cardiac Anomaly

  • WPW is a congenital disorder, meaning it is present from birth.
  • It is due to the incomplete regression of embryonic conduction tissue.
  • The genetic basis is not fully understood, but mutations in PRKAG2 gene have been associated with familial WPW.

2. Genetic Factors

  • Some cases have a familial pattern, suggesting an inherited component.
  • WPW can be associated with certain genetic syndromes, such as PRKAG2-related cardiac glycogen storage disease.

3. Associated Medical Conditions

  • WPW is sometimes linked to other heart conditions, including:
    • Ebstein’s anomaly (a congenital heart defect affecting the tricuspid valve)
    • Hypertrophic cardiomyopathy (especially in familial WPW cases)

4. Spontaneous or Idiopathic Causes

  • In many cases, WPW occurs sporadically without a known genetic or structural abnormality.

Conclusion

WPW is a condition that typically arises from congenital anomalies in the heart’s conduction system. It may have genetic influences, and in some cases, it is associated with other heart disorders. Proper diagnosis and management, including electrophysiological studies and ablation therapy, can help prevent complications related to arrhythmias.

Source recommendations

1. American Heart Association Guidelines on WPW

  1. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/other-heart-rhythm-disorders
  2. https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
  3. https://www.ncbi.nlm.nih.gov/books/NBK554437/
  4. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.929372
  5. https://pubmed.ncbi.nlm.nih.gov/22579340/

2. European Society of Cardiology Guidelines on Supraventricular Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  2. https://academic.oup.com/eurheartj/article/41/5/655/5556821
  3. https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
  4. https://pubmed.ncbi.nlm.nih.gov/14557344/
  5. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84

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