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Doctors' Answers to "Frequently Asked Questions" - Wolfe Parkinsons White Syndrome

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 04/27/2000]
Question: My husband has had WPW for five years probably all of his life but has
never known it, He has had two ablations that have been unsuccessful
he is in the military stationed in Germany they want to do another
ablation, and I know this may sound strange but his heart also makes
this popping sound as if it's popping bubble gum a hand ful of people
have heard this, can this be more than WPW I can hear it when we are
sitting on the couch it's very scarey not knowing what this is and
any clue as to what this nose is would be appreciated, I dont believe
it to be indegestion cause ive never heard anything like it in my
life and my second question to you is how many ablations can you
have to say that these are not working on this person and to
try a new procedure, it is dangerous after the tenth ablation?
The longest palpation he has had was thirty minutes and he was
very lathargic and cold, any input to help me figure out how
to help him would be greatfully appreciated.

Answer: Well, I have no idea what the sound would be, but I doubt it is related to his cardiac conduction system. As to the ablation, I would have the military send your to Walter Reed or one of the high level referreal centers. Sounds like you need someone with a different set of skills. There are times when it cannot be ablated,but WPW is one of the easier ones to ablate usually.

Wolff-Parkinson White Syndrome - Catheter Ablation [posted 7/27/98]
Question: I was just diagnosed with Wolff-Parkinson White Syndrome. For the past 15 years (I am 27 now) I was told I had SVT and have been taking verapamil (calan sr) 240 mg every day since then. Yesterday I was told to immediately stop taking verapamil by my new cardiologist and begin taking a beta blocker called sectral 200 mg. The cardiologist specializes in electrophysiology and highly recommends that I let him perform a catheter ablation to take care of the problem. Before I make a decision to undergo such an invasive procedure I would like to learn about the risks associated with both the procedure, taking the beta blocker (especially if I want to get pregnant in the next few years) and the risk of atrial fibrillation if I do not undergo the catheter ablation procedure. Can you help sum up the risks for me or at least point me in the right direction so I can logically think about this issue?

Answer: This procedure has been available about 10 years or so after pioneering work at the University of Michigan. There are many physicians who perform this procedure, but if it were me, I would go to one of the national specialists (assuming your health insurance will allow you) unless your physician has done over 100 or so. The risk is that you will damage the conduction system of the heart and need a pacemaker. Initially, there were also times that patients had damage to the heart muscle itself, including a couple of holes. This doesn't occur any more since the procedure has been perfected, but is still a risk. Basically a catheter is placed next to the accessory pathway responsible for WPW and radio frequency waves damage/kill the tissue so that it doesn't function. I have had about 4 patients receive the procedure and it seems quite effective. Some still have arrhythmias - different and easier to control than before. As to alternatives, it depends on how often and how severe your symptoms are. If the medications completely control the symptoms, watching might be an alternative. However, you are very young and this will not go away until "fixed". I'd probably recommend the procedure unless you are completely controlled currently, which I doubt or you wouldn't have gotten to an invasive cardiologist. The beta blocker would have little/no effect on a child - at least with current thought. Ask to speak with other patients who have had the procedure with this cardiologist.

Wolfe Parkinsons White Syndrome
Question: Could you provide details about this disease, what it is, it's causes, effects, dangers and treatment? I'd welcome a detailed discussion and suggestions for patients... thanks.

Answer: It is an Electrocardiographic syndrome and is congenital in origin. There is a tract present which enables the impulses from the upper part of the heart to reach the lower part after by passing the normal impulse tract which can result in very rapid beating of the heart called an arrhythmia. Catheter ablation is successful in 95% of patients.

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