Re: infantile wolfe parkinson white syndrome

Posted By jeremy on October 11, 1998 at 09:03:44:

In Reply to: infantile wolfe parkinson white syndrome posted by Jan Smith on October 05, 1998 at 19:29:17:






: my 6 week old daughter has had 3 episodes of tachycardia brought on from wpw syndrome, latest being this weekend.
: She has been through digoxyn and  atenolol, both lasting for a couple of weeks and then reverting to SVT. She is now on both which seems to be controlling it.
: What is the short-medium term prognosis if both these drugs together do not work?
: is there an operation that can safely zap the pathway? what are the success chances of this operation in a 6 week old girl?
: thank for your time
: jeremy
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Dear Jermey,
Q: What is the short-medium term prognosis if both these drugs together do not work?
A: There is an excellent prognosis regardless of the effectiveness of the drugs.
Q: Is there an operation that can safely zap the pathway?
A: As you can read about below ablation can cure WPW.

Q: What are the success chances of this operation in a 6 week old girl?
A: You would need to see a pediatric electrophysiologist (found at a major University children's hospital) to discuss the timing of the ablation and the success rate.  It should be high.

Wolff-Parkinson-White (named after the three doctors who first described it) is a hereditary condition.  It may not be diagnosed until adolescence but the underlying cause is present at birth.
Q: What is the normal condition?
A:In a normal heart the atrio-ventricular or A-V node is the only path for electrical conduction between the atria and the ventricles .
Q: What is the Wolff-Parkinson-White syndrome?
A: If an abnormal conduction pathway runs between the atria and the ventricles, the electrical signal may arrive at the ventricles too soon. This condition is called Wolff-Parkinson-White syndrome (W.P.W.). It is recognized by characteristic changes on the electrocardiogram that indicate that an additional pathway or shortcut from the atria to the ventricles exists. Many patients with the syndrome do not have symptoms or episodes of tachycardia (rapid heart rhythm).
Q:  First of all, what is the cause of WPW? Is it something you 'get' when you over exercise?
Is it genetically rooted?
A: WPW is a congenital condition.  It is not induced by exercise or any other "strain" on the heart.
Q:  How common, in the general population is WPW?
A: The incidence is about 1 in 1000.
Q: How is the Wolff-Parkinson-White syndrome treated?
A: If a person has episodes of tachycardia , often they can be controlled with simple **************. However, sometimes such treatment doesn't work. Then the person will need to have further tests of the heart's electrical system. The procedure most frequently used to interrupt the abnormal pathway is radio frequency ablation. (http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm)

Most patients with the syndrome can lead normal lives with no restrictions on their activities. This is true even for those who have episodes of tachycardia.
Q: How safe is the ablation? What are potential problems that may arise either during the ablation or afterwards?
A: Ablation is a routine procedure that uses high powered frequency waves to "burn" electrical short circuits in the heart.  As with any medical procedure there are potential risks and your doctor should discuss these with you prior to the procedure.
Q: Is there any kind of a rating system for the doctors which perform this type of procedure, simply put are some doctors better than others at this procedure and how may I find out who is the best?
A: There are no rating systems per se of individual doctors.  You can ask for success rates of the same procedure in other patients.  There are ratings of hospitals that are published by independent groups such as US News and World Report that give a ranking of programs.
Q:  How common is this procedure and how many are performed daily, weekly or yearly?
A: This is a routine procedure. The number will depend upon the individual group.  The electrophysiology group here does 2 to3 ablations a day.
Q:  Is it common for a cardiologist to recommend the ablation after only reviewing blood tests, and ekg, and an echo test of the heart?
A: Yes.  The diagnosis of WPW is made from the EKG.
Q:  I am currently taking the drug Diltiazem which seems to be controlling my heart problem. Therefore, if I were to postpone the ablation procedure could I possibly be putting myself in danger of further heart problems?
A: This would depend on your specific case and you should discuss this with your doctor.
Q: Are there famous celebrities or scientists, doctors, et
cetera, who have survived this infliction?
A: Not that I know of.  Anyone out there know?
Further information can be found at:
http://www.merck.com/!!vDXoe16kTvDXpz08Of/pubs/mmanual_home/chapt16.htm
http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist.