re-occurance of WPW?

[oc_chicks]

At the age of 5 my son was diagnosed with WPW.  Shortly after he had the ablation procedure.  As I understood the procedure and the condition, he was "cured". As our doctor put it, he could now even be a pilot.  He is now 13 and recently has been having the same rapid heart beats (200+ per  minute).  Through the valsalva manouver he can stop it.  I have heard the term "breakthrough"... can the original ablation spot fail?  Is this a new point of "break through"?  Could it be completely unrelated?  We do have a cardiac appt in a week but of course my curiosity is growing.

Thank you.

[Marie M Gleason, M.D.]

Dear oc_chicks: Wolf-Parkinson-White (WPW) syndrome is a name for a specific type of electrocardiographic finding that occurs due to the presence of an additional conduction pathway within the heart called a Kent bundle.  When electricity goes down the Kent bundle, it results in the characteristic appearance on the electrocardiogram (ECG) called a delta wave.   In many patients with WPW, a rapid heart rate called supraventricular tachycardia (SVT) may occur.  This pathway can be inactivated by radiofrequency and cryoablation procedures, which do have an excellent “cure” rate, generally 95 to 98%.  But that does mean a failure rate of 2-5%.  Failure can refer to one of 2 things: 1) the Kent bundle may not been fully inactivated, in which case the baseline electrocardiogram would still appear abnormal with a delta wave present, or 2) SVT may recur due to the presence of other abnormal conduction pathways in different locations from the Kent bundle, that were not demonstrated at the time of the original ablation procedure.  So the situation that your son is facing is not the most common, but it is not rare.  Your cardiologist will need to examine the  ECG for a recurrent delta wave.  Then they need to document what type of rhythm that your son is now feeling.  They may utilize holter monitoring, trans-telephonic event monitoring, or stress testing, depending upon how frequently and when your sons new palpitations are occurring.  Then based upon what is discovered, your cardiologist will let you know if an additional ablation procedure is indicated.

[oc_chicks]

Thank you for the informative, easily understood posting.