Wolf-Parkinson-White or Anxiety?

[ShawnMN]

I was recently at an Urgent Care being treated for anxiety/panic symptoms and the EKG showed Wolf-Parksinon-White Syndrome.  I followed-up with a cardiologist who is recommending an ablation procedure.  I have a LONG history with anxiety and am now confused as to whether my symptoms were attributable to anxiety or WPW.  I have a couple of questions...

(1) if I was having tachycardia, wouldn't I have been able to tell by my own pulse rate?  My pulse was 84 at the Urgent Care.  I have seen it go as high as 124 in anxious situations, but from what I have read WPW would cause heart rates in excess of 150 or even 200 in order to cause symptoms.  When I asked the cardiologist, he said I probably couldn't feel the extra heartbeats because they were too weak.

(2) Is the ablation procedure for WPW usually recommended without first being assessed with a home monitor/event recorder to ensure that symptoms are being caused by WPW?

Many thanks,

-ShawnMN

[MichelleP_3811]

From what I was told WPW can present at slower heart rates if the path is long.  My svt was around my avnode and was a very short path which led to a heart rate around 230.  WPW may present at rates as low as 150 if the looping signal is around the whole anatomy of the heart though I would check this out with a doctor to be sure.  That said, I do believe even when one isn't necessarily in tachycardia there may be some sort of pattern in the wave form that is seen in WPW that is not seen in a normal EKG.  But I do completely understand wanting to get a second opinion before jumping into an ablation.  They are expensive and no procedure goes without risk so I would say if you want to be doubly sure ask for the monitor to get confirmation on what you may have.  Good luck and keep us posted.

[Bromley]

(by home monitor, I assume we are talking about a two or three probe device used to capture really simple surface information; not something elaborate).

[Bromley]

I am no doctor, but I believe there are heart conditions that can cause anxiety. And I do not believe that having WPW contribute to your anxiety is beyond the realm of possibilities. This is something you should explore with your doctor.

Some people are perpetually in an abnormal heart rhythm. If this is your situation, and you have not known it because your heart beats are weak, or all feel the same, it would not surprise me if your heart issue was behind your anxiety.

The home  monitors do not record heart beats as well as in hospital EKG machines. If you were in an abnormal rythmn while at the hospital and were attached to a 12 lead ecg machine for instance, there is a good chance that the doctor would not need to give you a home monitor.  If this is your situation, consider yourself lucky.  Most people are forced to make an ablation decision based on inadequate data from a home monitor.

[tom_h]

apologies for the typos.  I've been typing in  darkness except for the monitor light.

[tom_h]

WPW and other "flavors" of AVRT, along with those in the AVNRT family often exhibit rates exceeding 250bpm.  As an adult, my episodes averaged 215, but as child it was recorded at 312bpm.  These types SVT have the characteristic sudden and abrupt initiation and cessation.  The feeling is unmistakable when it starts up, and is accompanied by a tightness in the chest and many ofen describe the feeling of their heart beating in their throat.  I always had a dull achiness along with a heavy weight on my chest.

WPW has the distinction of having a telltale marker while in NSR that is not present with other SVTs,  It was first though that I had WPW as my trace showed a very faint slur in the delta wave, but during the EP study they determined it was not WPW but another variety of AVRT called Circus Movement Tachycardia.

Many of us here have described a similar route that eventually led to an EP study and ablation.  This path first included drug therapy, stress tests, echo stress tests, and always long term monitoring.

I wouldn't rush into an ablation without first having these tests performed.  The cost of the procedure is in excess of $75,000, so when you go in for one, you want to be sure of a preliminary diagnosis, and a good chance that it can be found and eliminated.

Having lived with my wife who suffered through years of panic disorder, I can tell you that specialized psycological counciling aong with low dose drug therapy (Paxil, and Xanax) resored her life to her and she now leads a life nearly free of an anxiety,