Wolf Parkinson White Syndrome

[Loly__0]

  I was diagnosed this week due to a six hour episode of svt and occaisional pvc,s. There were Delta waves on my Holter monitor test along with svt  basically with any moderate physical activity. My concern is I`ve   been accepted into the Invitro program for infertility related to moderate endometriosis with implants on my pelvic nerves, will the fertility drugs and pregnancy aggravate this condition? My insurance company will probably not want to pay for Ablation per my Cardiologist because I have only been seriously compromised just once. I have palpatations daily for anywhere from 5 to 30 minutes with that feeling of not being able to catch my breath. Another issue is I have hemiplegic migraines that I have to take Verapamil for it's the only drug that ever worked. I have stroke symptoms as my predormal and during attacks. When I had the six hours worth of SVT I also began having my stroke symptoms without the headache. My Neurologist did a Hypercoagabilty study and found no abnormality. Basically, I am trying to gather enough information so as to enlighten the insurance company to comply with my treatmant.
                                                                               Sincerely,  
                                                                                          Lolly Ortiz, RN, CCRN

[CCF Cardio MD - MTR]

Dear Lolly, thank you for your question.  I don't know of any information regarding SVT and infertility drugs, so I can't say whether the IVF process will put you at risk for developing SVT.  However, if you become pregnant, you may be more prone to developing SVT (which should be relatively easy to treat) due to the hemodynamic changes associated with pregnancy.  Also, verapamil should not be used if WPW is present because it can preferentially block conduction down the AV node and allow unimpeded conduction down the accessory pathway.  If atrial fibrillation develops in this setting, the rapid atrial rate can be conducted down the accessory pathway to cause ventricular fibrillation.  Thus, if you do have WPW, verapamil is not a good drug to use (even though it may help with your migraines).  I can't determine whether you need an ablation procedure now, but ablation is the standard form of treatment for accessory electrical pathways in the heart and should thus be covered by insurance.  The advantage of ablation is that it is a one-time procedure that is usually curative.  I suggest that you speak with your cardiologist regarding the indications for ablation and hold off on the IVF treatments until this issue is settled.  
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.