Pediatric Heart Expert Forum
Wolff Parkinson Disease
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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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Wolff Parkinson Disease

My 10 year son was diagonosed with WPW(white syndrome).

His pediatric has suggested a cathere surgery is best if he does not want to take his prescribed atenolol medicine the rest of his life.
The stress test did not reveal the arrthynia only at rest.

Can we avoid the cather surgery, by just giving him the medicine or will his condition over the years not improve.
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773655_tn?1340656399
Wolff Parkinson White syndrome (WPW) is a congenital condition of the heart where, in addition to its normal electrical pathways, there is an accessory pathway (Kent Bundle) that connects between the upper and lower chambers of the heart.  Accessory pathways can be single or multiple.  In WPW, the accessory pathway carries electricity from the upper to the lower chambers, in addition to the normal pathways, and this side pathway shows up on a electrocardiogram (ECG) as an extra bump called a "delta wave".  Under certain circumstances, the accessory pathway can conduct electricity back to the upper heart chambers that results in a rapid heart rate called supraventricular tachycardia (SVT).  In a minority of patients, the rapid heart rate can be fatal.  The diagnosis of WPW is made under a variety of circumstances: it can be found in patients with palpitations, or it can be an incidental finding on an ECG in a person who has no symptoms. Due to the potential arrhythmia issues, treatment with beta-blocker medication is commonly instituted.  An alternative treatment is a cardiac catheterization, electrophysiology (EP) study and radiofrequency ablation (RFA) of the accessory pathway, so that the arrhythmia cannot happen.  You do not state whether your son had symptoms or not at the time of his diagnosis with WPW.  Sports participation may also be influenced if a child has WPW and an arrhythmia problem.  WPW will not go away by itself if it is found at this age.  It does pose an incremental risk for sudden death annually and will require long term follow up and possibly long term medication management, if the pathway is not ultimately ablated. You need to work with your pediatric cardiologist to assess your child's risk for the serious type of arrhythmia.  Consultation with a pediatric electrophysiology specialist would also be helpful in getting more information for you and your son.
6 Comments
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Avatar_m_tn
Thanks for your reply. Doctor I just received my son's report, test from Winthrop Hospital can I submitt it for you to reveiw.

My e-mail is ***@****
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773655_tn?1340656399
If your pediatric cardiologist feels that another opinion is indicated, then they can forward information to review.  It would not be appropriate to receive medical data directly from you.
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Avatar_m_tn
My son cardologist approved of him playing soccer.

We on the other hand are very concern that he should discontunie.
We have not even allowed him to play x-box and other games that are so tense.

He is so activate and likes to run and play.

He has been playing since the ageof five.

What are the probability do you know of when we visit our physilogosit if heb does a catherter procedure that this will re-occur.


Do you know of any other means that a doctor will treat this other than inavsive procedure.


Such as are their foods that will help.
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773655_tn?1340656399
When a person has a radiofrequency ablation, the success rate is 95-98%.  So there is a very small risk for recurrence (in which case, the invasive procedure can be repeated to get the additional pathways that sometimes manifest themselves at a later time).  But if successful the problem is gone.  Medications just suppress the risk for arrhythmias, they never get rid of the WPW.  Foods do not make a difference. These are really the only treatment options for WPW.
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Avatar_m_tn
Yesterday, I visited Dr.Pass from Montefoire Hospital and he was very detail as to the ablation procedure that we were somwhat at ease.

He explained that it entails 2 to 3 hours of surgery a one day overnight stay.

In addition, he stated that if the arrhythmia is too close to the node of the heart he would pull out and leave it, as is.

He assured us a success rate of 90% to 95% that he would be cure.

The procedure would be done on a Thursday and he would return to school on Monday.

He could then lead an active curriculim.

We have to decide if we go ahead with the procedure for September 23, 2010.

He also prefered that two weeks prior to the surgery that he stop taking his atenolol medicne.

This would enable him to discover the arrhtyhmia much sooner.


Is time of the essence.




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