Some patients develop problems with the electrical connections of their hearts due to congenital abnormalities. One of the most common congenital abnormalities that affects the heart's electrical system is Wolf Parkinson White syndrome (WPW). In patients with WPW, an electrical pathway exists other than the normal connection between the atrium, the AV node, and the ventricle. This alternative connection sidesteps or bypasses the normal pathway. The additional pathway can cause a short circuit, enabling the heart rate to unnecessarily accelerate out of control. Some patients with this condition have had their heart rate accelerate to 300 to 400 beats per minute, a potentially lethal pace.

EKG of a patient with Wolf Parkinson White syndrome.

In the past, physicians eliminated these additional connections through either removal or disruption during open-heart surgery. Today, we can use a much more limited, catheter-based approach known as ablation to identify and destroy these pathways while leaving the rest of the heart intact. For those patients whose normal fibers may also be disrupted, we can implant a pacemaker to support the heart's normal electrical function.