wpw 5%

  WPW almost killed me between birth and the age of three.I am 34 now,in 1964-1967 they did'nt know the cause of my rapid heartbeat.they could'nt even get an accurate count on it.They treated it with (digitallis not sure if I spelled it correct)and said i would grow out of it,and everyone thought I had.Through out my life begining around the age of 14 I began having svt's,not often maybe 3-5 times a year until I tuned 32.Thats when they became more often and lasted longer.Over the years I learned how to stop them,but three months ago,at the age of 34 they became much worse and I could no longer stop them.They began lasting for hours up to 7 at a time.I know it was dumb now,but i never sought medical attention for my problem until a week ago.Thats when I found out I have wpw,the abnormal delta wave was easy to see.I wont go into eveything that took place in the ER but my heart rate was 214.After being diagnosed with wpw DR.Schmidt of Ruby Memorial Hospital in Morgantown,WV said I needed a ablation.               After understanding what was going on I had the procedure,which has a 95% sucess rate.I fell into the 5% who have a web of extra tissue,although he spent 8 hours and used every trick he knows it failed,also to make matters worse my web of extra tissue is on the most uncommon side.He put me on sotalol and wants to try another ablation,since I am high risk because of heart problems in my family.He gives it a 50/50 chance of sucess this time.I am looking for more information or case studies on wpw patients who fall in the same area as I do.I have not had svt's since I've been on the medicine,but i've been taking it easy.I'm waiting to have the second ablation hoping it works,now that I know I have this going into svt's again scares me.any info or input will be greatly appriciated.

[Cleveland Clinic, MD]

_

Dear Evan,
Wolff-Parkinson-White (named after the three doctors who first described it) is a hereditary condition.  It may not be diagnosed until adolescence (or later in your case) but the underlying cause is present at birth.
As you said not all ablations are successful the first time and may require a second attempt.  More information concerning ablation may be found at: http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm

Here is some additional information on WPW.
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.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
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.