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876405 tn?1243511886
Possible WPW
So, I went to a new cardiologist today to get a 2nd opinion..and I was told that I might have WPW or another type of accessory electrical pathway problem that contributes to the PVC's PAC's and the PSVT. He sent me home with  30 day holter monitor. So, I have had this my whole life and until recently it has just showed up? It seems pretty strange that I have only been getting the PSVT for the past 3 years and PVC's and PAC's for the past 4 months. (Since I have been pregnant.) How do they know for sure that this is what thr problem is and could it be something else instead?? I am very confused as to how they actually *Diagnose* WPW.  I am also very anxious and freaked out today..thanks!
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612551 tn?1450025775
Try to remain positive, I understand WPW is usually responsive to the ablation procedure for a cure, if one is needed.  

It would be beyond my expertise to try to explain how "they know", but I believe a board certified cardiologist is expert at such tasks, and go forward with whatever they tell me, even if it involves surgery, as it did a couple of years back.

Happy 4th, try to enjoy your weekend, and just ignore the monitor, I found them easy to wear.
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267401 tn?1251856096
I don't know how they know either, but in the research I've done over the last year, that's a pretty common thread, that many people with WPW never have symptoms and never need treatment.  Some develop symptoms and need treatment, and that treatment, often an ablation, tends to be very successful.  Doctors have given professional hockey players with WPW clearance to play, and even the singer Meatloaf was just diagnosed with WPW within the last few years, after fainting onstage during a concert in England.  And he's 61.
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876405 tn?1243511886
Thanks for the responses,the diagnosis of WPW just makes me nervous for some reason, especially since I am pregnant.I don't want to drop dead! I guess I can't do anything about it, but was just wondering if there were more definite tests out there to diagnose it other than, "well you might have this, but we're not sure".  Anyone know if it is still safe to exercise? ( I am not a big one to exercise but I like to walk and stuff, but lately even the slightest movements set off the SVT so I have been avoiding it alltogether..) Thanks!

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It can be frustrating wondering what's going on with your heart -- and sometimes scary when they throw around various possible diagnoses. However, getting a second opinion seems like an excellent step to take.

WPW is just one of the types of accessory pathways that cause certain types of tachycardia -- including, commonly, PSVT. It is believed these pathways (connecting between the atria and ventricles) are present from birth and that they sometimes inherited and other times the result of a slightly anamolous development of the heart during the fetal stage. Studies seem to suggest that the majority of patients with these types of pathways are actually asymptomatic and it is not uncommon for someone to develop symptoms suddenly as seems to be the case with you. Interestingly, some patients who have WPW, who may or may not also have symptoms, actually outgrow their WPW -- the pathways seem to "disappear" and the EKGs of these patients become "normal" again! So, while your symptoms may seem odd and be frustrating, it is probably not that unusual. Also, it is not unusual to find people reporting more symptoms, sudden episodes or "unmasking" of accessory pathways during and after pregnancy -- there are various opinions on why that is, but for the most part it does not seem to affect either the mother or the baby as long as it is being monitored. Other physical and emotional stressors, such as excessive athletic training, starvation dieting, severe workplace stress, etc., have been anecdotally associated with sudden onset of symptoms in a large number of patients. As with all medicine, arrhythmia treatment seems to be as much an art as a science, so I think it is important to listen to your body, find providers you trust and feel comfortable with so you can concentrate on being positive, happy and healthy for yourself and your baby.

As far as diagnosis goes, in some patients, there is a very clear delta wave on the EKG readings, which is usually considered "definitive" for a WPW diagnosis. Other patients have a transient Delta wave that comes and goes and is often only seen on holter monitor results, during stress tests or when they are in the ER in having episodes. Still others are not diagnosed until they undergo an EP study and they find the pathway and see the EKG readings under direct stimulation of the heart.

As mentioned, WPW is considered one of the more easily ablated Accessory Pathway conditions, but it is not the only accessory pathway condition that can cause your symptoms and many of the other types also have high success rates for treatment. That's why the additional testing may be valuable. Try to remember that the majority of people with these conditions and symptoms are at very low risk for anything serious and most either get treatment or find a way to live with it. Additionally, you may, or may not, find your symptoms improve after the baby is born. If it is any help to you, I like many others, have WPW and have lived a very full life with it for over 40 years. Good luck and keep us posted!
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