I posted back in Nov re: WPW and have some follow up questions. My history is: 37 yo female, regular exercise, healthy diet, low cholesterol, non smoker, 1 grandparent who died of heart attack. 10 years ago I began having palps. I consulted a cardiologist and had EKG, holter test and echo. All were normal. EKG indicated I had a "borderline short pr-interval". Holter test captured "3 short bursts of SVT, occasional PACs and PVCs". I was told I had nothing to worry about. During a c-section last Oct, I experienced an arrythmia and the anestisiologist noted I had a "delta wave". An EKG in the recovery rm was read by the same dr who again noted a "delta wave". However, a cardiologist who read the same EKG did not note a delta wave, only a short PR int. In Nov, I saw a cardiologist and 2 different EPs. I had several EKGs, an echo and an event monitor. This captured PVCs at rest and during exercise. All 3 docs told me the same thing: they saw no evidence of WPW or preexcitation, the PVCs were benign, and to come back if I ever experience tachycardia. They all noted a short pr int as well. I am relieved that I don't have WPW but I'm confused by the short pr int. My questions are:
1. What does a short pr int. mean? Is this dangerous?
2. Why was the interval short on some EKGs and not others?
3. I have never experienced SVT. Is it likely I will as I age?
4. Am I at any risk of sudden cardiac death?
5. I'm a runner and concerned about exercising. Do I need a stress test? I captured PVCs on event mon during exercise.Is this a good enough?
1) The PR interval represents the time from the onset of atrial depolarization to the onset of ventricular depolarization. It is a measured time on the surface ekg. A short PR interval may also occur as a normal variant, although it is much more common in the pediatric population and at faster heart rates. In itself it is not dangerous.
2) See above regarding heart rate variability. Also, the machine may be off a bit in it's measurements.
3) The baseline risk is truthfully not known, but should not increase to any degree as you age.
5) Most likely not from the information you mention. Event monitors and stress testing look at different things and one doesn't substitute for another.
Thank you for your reply. I was reading another posting about WPW and concealed accessory pathway. Is it possible that I may have a concealed pathway since my EKGs have been normal except for the short pr interval? I have never experienced tachycardia (that I know of) except the short bursts (3 beats) noted in my holter monitor test. If I did have a concealed pathway, with all the testing I've had done over the past 10 years, wouldn't the drs pick up on it? I'm really uptight about my heart since I'm only 37 and have 3 children. It makes me nervous to know there is even a small risk of death for people with a concealed pathway. I guess I'm seeking some reassurance I am not at risk of death or a future of heart problems. I want to make sure I do everything I can to make sure I'm around to see my children grow up!
I just wanted to add a comment about the short p-r interval that may make it seem a little less worrysome. I also am 37 and have 3 kids, and I was recently told that I have a short pr interval. I was in the clinic feeling weak, ill, and dizzy (thinking it was a virus) and the ekg revealed the short pr interval. The doctor set me up with a follow up in Fam. Practice which I am scheduled for tomorrow and I may have to go for a complete cardiac workup. He also said it may just be anxiety and episodes of "panic attack" which I don't believe. Though I do often have alot of stress with 3 kids, a house, 3 pets, and full time college courses, I can usually handle it all pretty well and have never had any type of anxiety attack before. The funny thing is that even though the doctor says I may have WPW syndrome, nobody seems to be very concerned about it but me - the nurse that I had to call to set up my appointment was very blase about it and actually pretty rude when I let it be known that I was concerned and wanted to be seen as soon as possible. I have been researching it all over the net, and for the most part it is not life-threatening and many people who are asymptomatic will not have to ever have any treatment. ON the other hand, if you are symptomatic, you could actually go into a life threatening arrhythmia suddenly. I have always been active and now that I have been told about this potential syndrome, it makes sense to me that I have always gotten overexerted in exercise very easily even in my best shape as well as getting dizzy very easily. I have even run a marathon and several 1/2 marathons, with little difficulty, but my heartrate does get up higher than it should for my age. I actually hope that they find this to be WPW and schedule me for the catheter ablation which destroys the extra conduction pathways so I can see if it makes a difference in my exercise. Also, I do often get lightheaded and dizzy, especially when I get up from sitting to standing quickly. Good luck to you and I'll check back to see if there have been any more comments since my post.
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