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Heart Disease (Expert Forum)
Wolf-Parkinson-White
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Wolf-Parkinson-White
by Anthony__0, Aug 19, 1998 12:00AM
Dear Doctor,
I was recently diagnosed with WPW. I am asymptomatic in that although
I get palpitations about 10 times a year, I have never lost consciousness
from them. The palpitations last about 5 to 10 minutes. An echocardiogram
was performed and my cardiac function was shown to be normal. An exercise
stress test was also done and it shows that during stress, the electrical
impulse travels down both the normal and the accessory path. Doctors
here at University of Chicago have recommended a cardiac ablation.
Do you feel this procedure is necessary?
Can you tell me about the risks of this procedure?
Can you recommend to me a couple of the best cardiologists at the Cleveland
Clinic for this procedure?
Thank you very much!
Anthony
Doctor's Answer
by CCF Cardio MD - MTR, Aug 19, 1998 12:00AM
Dear Anthony, thank you for your question. WPW is a disorder that occurs when electrical impulses from the atria (top chambers of the heart) are conducted down an accessory pathway (AP) to the ventricles. Normally, all electrical activity is conducted down the AV node to the ventricles which has a natural "brake" that keeps impulses from being conducted too fast to the ventricles. An AP doesn't have that natural brake and is able to participate in a reentrant circuit of electrical activity that is called supraventricular tachycardia (SVT). Your palpitations are caused by periodic bouts of SVT. SVT rarely causes serious problems, but can be quite a nuisance to patients and can occasionally cause loss of consciousness. Radiofrequency ablation (RFA) is a procedure performed with catheters to eliminate the AP with controlled radio wave energy. The test is performed by placing several catheters into the right side of the heart via the femoral vein located in the groin. The AP is "mapped" to a certain location and then radio wave energy is applied to the AP through a special catheter. The AP is eliminated with RFA and no longer participates in SVT so the palpitations stop. The main risks of the RFA procedure are bleeding from the groin where the catheters are placed, damage to the structures of the right side of the heart with the catheters, and infection. These risks are minimal, however, and occur in less than 1 in 500 procedures performed. Most patients with WPW opt for RFA so that palpitations are eliminated and their activities won't need to be restricted. We have a number of cardiologists here who are quite skilled at performing RFA procedures and they would be happy to evaluate you. For an appointment, call 1-800-CCF-CARE and ask for an appointment at Desk F-15 with Dr. Kidwell, Dr. Tchou, or Dr. Augostini. I hope you find this information useful. Information provided in the heart forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physicians.
