Pediatric Heart Expert Forum
WPW Ablation
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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WPW Ablation

Hi, my son is 13 years old. He is in great health. We went for a cross country physical and his EP Dr. decided to do another EP test. My son had one done in 2006. During the test his Dr informed us he felt Mikey needed an Ablation. My son was in surgery for 12 hours and then we find out that his Dr ablation is AV node. The thing is his Dr now says it shouldnt have happened because his WPW was no where close to his AV node. Have you ever heard of this before?? Why would a Dr say it shouldnt have happened if it is something that happens during ablations?? Mikeys EP Dr nevr tried him on any medicines, nothing.
773655_tn?1340656399
If your son has an EP doctor, then I assume that his WPW yndrome was a known diagnosis for some time.  How people are diagnosed with WPW varies: sometimes they have symptoms of palpitations and the delta wave is seen on an electrocardiogram (ECG) or it is an incidental notation on an ECG done for other reasons.  The decision to start medication in patients with WPW depends upon whether they are having cardiac symptoms, have demonstrated arrhythmias, or are considered high risk.  The decision to do a cardiac catheterization and radiofrequency ablation in WPW depends upon the presence of symptoms, or failing medical therapy, or in cases of athletic young people, to try to get rid of the bypass tract so that no medication is needed and no restrictions would be needed in sports.  When you say your son had an EP test in 2006, do you mean he had a cardiac cath and electrophysiology study to assess his risk?  if no ablation was done then, they must have thought his risk for a serious arrhythmia was relatively low.  However, every EP doctor will tell you that, although the risk of injuring the normal conduction system (AV node) is low, it is never zero.  As such, the chance of causing heart block and needing a pacemaker always exists with an ablation. Fortunately it is an infrequent event, so yes, we have seen it before. Often the WPW pathway maps far from the normal conduction system, making the risk lower, but on occasion, it can be relatively close.  Remember that the heart is beating and moving during these procedures, and even a few millimeters off can get you into trouble.  So during informed consent for such a procedure, this should always be mentioned.  If you have further questions, I suggest you discuss them fully with your son's EP doctor.
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