Atrial Fibrillation and Wolff-Parkinson-White (SVT)

[anddan]

Hello,
I am 44 year old male with long history(more 20 y) of SVT.
WPW documented on ECG and even recorder, but my ECG show d-wave only occassionaly and d-wave disapea on the pick of the exercise-stress test. Echo, stress echo both normal.Episodes of SVT usualy
short(few minutes) and self terminated.Symptoms of my SVT - I am avare of palpitation and anxiety during episode.
But now I had my first episode of AF. It lasted 8 hours and converted by itself. I am very scared now.
I show two cardiologist and one offer ablasion of the accessory pathway. Another said that my WPW intermitted( d wave seen very rare on ECG and disapear with exercise) and I can go with meds.
I am taken now atenolol 50 mg and aspirin.
Mu question
1. If ablasion of accessory pathway may prevent future AF( at least 50%)
2. What another option I have to manage my condition

THank you

[CCF-M.D.-MJM]

Hello anddan,

I understand your concern. It is frustrating to get two differing opinions on the same question.

1.  WPW ablation will not treat the AF.  WPW ablations are relatively easy procedures, the AF ablation is technically more complicated and usually takes longer.

2.  If it were me, I think I would get the ablation.  AF and WPW don't mix very well.  It is true that delta waves that dissappear during exercise suggest a more benign course, but if the AF conducts with the WPW, it could be pretty dangerous.  This is still a judgement decision, but I would lean toward ablating it.

Grant it, this is a very unofficial opinion since I haven't seen your records or talked to you about your symptoms.  From what you have written, this is what I would do.

I hope this helps.

[Ling]

I am 3 days  post ablation for SVT. The exact terminology was ANRVT.  I had bad PVC's as well.  They feel like the tachy triggered the pvc's.  I do notice though, that I am still having pvc's.  I just wonder if this changes during the healing period?  Anyone know?

[hankstar]

As far as I am made to understand the PVCs should subside with the healing process and reduction in inflammation.

I always thought AVNRT and PVCs go hand in hand either one triggered the other or vice versa, was your ablation for AVNRT or AVRT. Was your biggest symptom frequent PVCs or tachycardia episodes triggered by PVCs or both? Just very curious because i strongly suspect I have a concealed pathway responsible for my PVC and tachycardia episodes.

I am sure everything will get back to normal soon.

Best wishes,

    Hank.

[wizkid]

Hi.  I am 45 yo with 20 year history of WPW. Episodes similar to yours, but no AFIB and, previously, no delta wave (concealed pathway). This former situation of mine was probably less serious than what you are dealing with now.

I went with the ablation and after 6 months of dealing with the results, am still trying to determine whether the ablation was successful.  The long bouts of SVT are gone, and the short bursts of "idiopathic" VT that ensued after the ablation have either disappeared or gone into remission.  I do however have occasional short bursts of SVT, and fits of PVC's and PAC's, which I did not experience before ablation. And it is not clear whether the VT will return.

In spite of this dubious outcome, I think that the ablation was worth the risk and trouble.  If you opt for it, accept only the best doctor that money can buy. Be sure you understand the risks. There are a lot, and most of them can have very significant repercussions to you.

regards,

[MelJaske]

Hello anddan,

I am 46 year old female and had ablation two weeks ago.  I presented with SVT, and sometimes A-fib occurred. When I was on the table I went into A-fib, but converted on my own, except for one time when I was in A-fib for about 4 or 5 minutes and they did cardioversion because they were about to ablate.  The ablation was done in the accessory pathways and my specialist believes the A-fib will not occur anymore.  We are still going to watch for it, but he thinks the SVT was triggering the A-fib.  It has only been two weeks and yes I have had many PVCs and PACs and sometimes it feels like I am about to go into SVT, but it stops and that feels good.  My specialist said that in time that sensation should subside.  I was diagnosed about 6 months ago and had tried several different medications, but they failed. I feel so much better not being on medication.  They really wore me out.  Of course each person is different when it comes to their tolerance for a medication.  When I decided to go ahead with the ablation, I found it very comforting to read the comments on this website from others who had the procedure. There were many successes.  I believe I am another success story.  If you decide to have the procedure, it is very important to have the right doctor. My doctor is director of EP studies at the hospital where I had it done and he is probably one of the top 30 doctors in the world who do this. I was lucky to have him.  Good luck anddan.  I hope you get the help you need and I will keep you in my thoughts and prayers.