possible WPW recurrence

I was diagnosed with WPW at age 20 and had an ablation at 21.  I have been on a beta blocker ever since to help control my tachycardia that still remains however, all my ekgs and holters have been clear of WPW.  My last ekg was read and I was told it supports WPW and I am being referred back to a cardiologist whom I haven't had to see in the past four years or so.  As a respiratory therapist I perform EKGs but I can only interpret your basics, not WPW.  The only thing I see on mine, and I could very definitely be missing something is that my Qtc is 453 ms.  Otherwise my PR is 132, my QRSD is 89, QT  is 432, and p axis is 25, QRS axis is 48, and T wave is 27.  I was in normal sinus rhythm.  I experience palpiltations on a regular basis but have for years and it was always chalked up to nothing out of the ordinary or that I'm just more in "tune" with my heart.  Any ideas or responses on my numbers?

Thank you for your time.
Jessie

[tom_h]

As a comparison, here's my reading 1 month post ablation for another form of AVRT called Circular Movement Tachycardia.

Vent Rate 82 bpm
PR 142 ms
QRS 84 ms
QT/QTC 370/432
P-R-T axes 40 28 23

The EP flipped me the printout and said "see ya!"

The ablated pathway can reconnect.  I believe it's happening to forum member Janpes.  Perhaps you can compare notes with her.  I found beta blockers did little to prevent episodes.  I still experience frequent clusters of PVCs even  while on 50mg of Metoprolol/day.  Hey, you've done it once, you can do it again, right!?

[turbulence]

Hi,
I was told I was small and could "feel my heart" by several doctors and a cardiologist. I ended up getting a cardiac ablation. I still have the same symptoms I've always had but they are a little less intense. All I can say is that from experience-a person knows when their heart doesn't feel as it once did! I'm not sure what WPW is. What is it?

[gibberina77]

I've been told the same thing, that I'm just more "in tune" with my heart beat than others.  WPW is when there is an accessory pathway in the heart.  Normally the SA node fires to the AV node with sends the signal along to the bundle of His and the Left and Right bundle branches and so on, which is the normal electrical pathway.  In WPW the SA node will fire put will be re-routed, if you will, to the acccessory pathway which is essentially a useless and unproductive pathway.  It cause various arrhythmmias, for me it was SVT or supraventricular tachycardia where my heart would beat in excess of 280 bpm.  I was started on medication but if proved ineffective and had the ablation.  I've had symptoms since but like yours, much less intense.  I take atenolol everyday but I continue to struggle with the symptoms and they feel slightly more intense.  But today, in a couple hours, I head to see the cardiologist in Iowa City and am hoping for some good or at least, conclusive news.

[gibberina77]

Your ekg results look very similiar to mine except for the QTC, which again is the only thing that seems abnormal on mine.  I usually never get to see my ekg results so it makes me wonder if it has always been high or this is new.  I wish they wouldn't act like our medical charts are so darn top secret.  Iowa city now has an online service called mychart which allows you access to all of your test results so you can see your exact values for anything that was ordered.  But like you said, if I have to have another ablation, so be it.  The first one wasn't so bad. Thanks for your response!

[Janpes]

Hello there,

I had an ablation for SVT almost 7 months ago and after 2 months of being SVT free I started to have small bouts of SVT again. I am now trying to catch an event using a portable handheld ECG machine. So far I have recorded one event in 3 weeks of irregular heartrate. Notice I said Irregular heartrate not fast heartrate as my pulse was 77 at the time I put the machine one. I am left to wonder has the ablation left me with a new problem??? I will return the machine on the 29.4 and the cardio should contact me on the 2.5 with the results.

My ablation was a difficult one and was 50/50 on the success part, cardio said it could go either way as the pathway was deep in the heart muscle and difficult to get to. He also couldn't use the full amount of wattage to the catheter as my heart would start going into different arythmias, in my case there is an increased risk of AV block.
He did say that he would do the ablation again and again until we get a good result and when everything else fails then he would insert a pacemaker as a last option.

I cannot tolerate beta-blockers due to already having low blood pressure (currently 95/67)

Anyway I hope you find the answers you are looking for and we are here if you need any help
Take care and Happy Easter

[gibberina77]

Thank you for your response.  They monitor my bp pretty close because I have been known to be as low as 79/53 so I cannot get an increased dose.  I'm sorry to hear that you are having such a difficult time with your ablation results.  I understand that some accessory pathways can be very difficult to get to.  I was told mine was a "complete success" and I think it was for a while.  But, as we all know, nothing in life is certain.  I think I'm more frustrated than anything because this has taken so much time away from life that I really want it to.  I'm hopefully getting answers today and I will share them with you!  Please keep us posted on your situation as well.
Best of Luck!
By the way, doesn't it always seem that when you have a holter or event monitor is when your arrhythmias mysteriously stop happening?

[turbulence]

I take a Xanax only when I have tachycardia or related episodes because my EP said that what I have is not life threatening. I'm not even sure what the diagnoses is; I'll have to look it up when I'm back up north at my house. I'm downstate for Easter. But the Xanax settles my nerves; a .25 mg.
I hope we all just heal!

[Janpes]

YEP! as soon as you get the monitors the heart goes back to normal....lol going to invest and buy my own and shock it into working good all the time.

Hope you have had some results from the doc.
While I have the monitor I am gorging myself on chocolate and caffeine in the hopes of sparking up an episode...what I have to go through ;)

[gibberina77]

The doctor decided to put me on a 30 day event monitor....again.  So I guess we will see what happens at the end of this 30 days.  Depending on what we find he said we may be able to do surgery but no increases in medication because my bp is too low.  Or I just may have to deal with it b/c it is probably not life-threatening, just incredibly annoying.  They also referred me to neurology for my migraines as I haven't been seen by one in probably ten years and my meds don't control them.  So eventually I should be all fixed up.  Hope everyone enjoyed their Easters!

[Janpes]

it was choco heaven...lol

Had my entrance exam today and I have to say that I was full of anxiety, and after reading the first page my heart gave some extra beats...Damn you adrenaline! It seems that when the anxiety kicks in the adrenaline seems to kick in too which then sends my heart pounding. Didn't have the monitor with me and not sure they would have even let me have it with me anyhow. WOuld have felt silly taking my heart monitor reading in the exam room :(
Anyway my brain is a little fried after writing an essay on Finnish banks embracing Corporate Social Responsibility :(  Tomorrow another entrance exam :( :( :(