SVTI

I'm a 25 year old female who has had SVT for as long as I can remember.  I take 25mg of Atenolol which controls it very well.  My cardiologist says that he is pretty sure that I have the AV nodal reentry type.  I was reading my records and it said that "the differential diagnosis was AV Nodal reentry or an accessory pathway that is septal in origin".  My first question is, is it possible to have an accessory pathway and not have WPW?  My records did say that I did not have any delta waves, and my EKG showed no signs of WPW, I even had an EKG while having an attack and that didnt show WPW. My other question is, is having an accessory pathway and not having WPW still as dangerous as WPW?  And my last question is, what do you think the chances of me having WPW, without having any evidence of it on any of the numerous EKGs that I've had.  Thank you for your time.

[ccf]

Dear kasey,
By definition an accessory pathway is Wolf Parkinson White (WPW) but not all accessory pathways have evident delta waves on surface ECG.  During tachycardia delta waves are not usually apparent.   I think the only way to tell for sure what kind of tachycardia you are having is to have a EP study.  I would recommend proceeding with EPS and possible radiofrequency ablation based on the results.