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Wolff Parkinson White Syndrome- Diagnosis

September 23, 2015

I had a catheter ablation for Wolff Parkinson White (WPW) Syndrome a week ago today. This is the story of my diagnosis.

NOTE: I am in New Zealand, so my experience is framed within the Public Health System here. It will be a little different around the world, no doubt.

I first started noticing heart palpitations when I was about twelve years old. My mother took me to the doctor, who didn’t believe I could have been counting correctly to come up with a heart beat of more than 200 bpm. I took her at her word and never bothered to count my heartbeat again! She did send me for an ECG, but we were supposed to ring up for the results and forgot to, so that was the end of that.

Down through the next 25 years, I would have palpitations from time to time. Many people say that they feel panicked; some people even think they are having panic attacks, when they are actually in Supraventricular Tachycardia (SVT)(Which is defined as a resting heart rate of more than 100 bpm). This was never the case for me. I would just have a massive head-rush and have to crouch down, or I thought I might faint, and then my heart would just take off. Once my head cleared, I could stand up and carry on with what I was doing, and the STV would  stop within a few minutes. As I aged, I noticed it would go on for longer, and it was harder to get it to stop. I worked out that taking a big breath and holding it helped sometimes, as did lying down flat. Of course there are lots of instructions online about how to get your heart out of SVT if you have WPW, but I didn’t have a diagnosis, so I didn’t know that.

I didn’t have many episodes at all, over the last few years. Then, on January 2nd this year, I was out walking in the bush with my sister, and working quite hard to climb a hill, when I realised I could feel my heart racing. I stopped and lay down; I held by breath. I got up and tried to ignore it. I lay down again; I tried to relax; I held my breath. Nothing worked. I decided we should head back to the car, as the middle of the bush is not a good place to have a Heart Event, if that was what I was heading for. My sister (bless her) does not drive, so I began to drive back to town. I only did so because I felt fine. I could see fine; my fingernails weren’t blue; I was not sweating; I could breathe fine. I was, for the first time, a little freaked-out, because I couldn’t get it to stop, and I could feel pressure in the right side of my neck and the underside of my right upper arm. For that reason, I decided it would be best to go to the Emergency and Medical Centre to be checked out.

After having to check ALL my details and fluff around for what felt like far too long, a nurse finally put the pulse and oxygen metre on my finger. The pulse rate jumped straight to 227 bpm. It was all on after that! I had an ECG, which recorded the speed of the STV, but didn’t give them any useful information, as it was going so fast. The doctor rang an ambulance, and as it arrived, a senior nurse told me I should try raising my knees while lying flat. I just put my legs in the air and that worked, straight away! My heart had been racing for over an hour at that point, so it was a bit stressed-out, so it was still going over 100 bpm, so the doctor elected to still send me to the hospital.

Once at the hospital, they did another ECG. Once the registrar had a chance to look at it, he came and told me that he could see from my ECG that I had Wolff Parkinson White Syndrome. He explained that people with WPW have at least one rogue electrical connection in their heart, which lets electrical signals through to the ventricles, which makes each heart beat look wrong, and makes the heart race sometimes. He explained that it was usually treated by catheter ablation, where they go in through the groin, trigger the SVT, find the rogue connection and fry it. He wrote a referral to the Cardiology Department at the hospital and then sent me home.

HEART PIXEL RED

My heartbeat, showing the ‘delta wave’ on the upstroke- a clear indicator of WPW

A few months later, I got my appointment to see the Cardiologist at the hospital. Before the appointment I had to have a blood test, where they tested all sorts of things, from liver function to electrolytes to blood sugar to cholesterol. All my results were in the normal range. I also had an Echocardiogram, where they look at your heart in three dimensions using an untrasound-type wand and make sure it is healthy and there are no other issues. My heart was found to be in good health- no wonky valves or thin bits or inflexible bits. Right before the appointment, I had another ECG, also. The cardiologist was a really depressed American who seemed to be missing his own health system quite a lot, as all he could focus on was how different things would be if I was in America. He is not my favourite Health Professional. He said he would refer me to the Big Hospital for an Electrophysiology Precedure and Ablation.

Because I didn’t quite ‘connect’ with the cardiologist, I soon made an appointment with my own doctor, so we could discuss things. I got copies of all my result and all the letters (because I have enough experience to know that you have to be your own advocate in the health system, and Knowledge is Power) and asked him to check that I had, indeed, been referred to the Big Hospital for the Ablation. He had his assistant check and they had never heard of me. They re-sent the letter my American had sent my doctor a copy of.

I soon received a copy of the letter from the Big Hospital, and an appointment to have a treadmill stress test at my local hospital. The reason for this is that, if you have WPW and the delta wave switches off suddenly when exercising, you have a low-risk form of WPW, and the Health Budget could be spent elsewhere, rather than on an ablation procedure. I was pretty sure it wouldn’t disappear, as it had happened while exercising a couple of times, and thought they could have saved more Health Budget if they just called me and asked some intelligent questions, but I am not the boss of them, so I turned up at the appointed time and had my treadmill test.

The letter had said that it was a walking test and that I could stop at any time. I gathered that these tests are usually administered to older people who have heart disease, so the ladies who did my test were not quite sure what to make of someone who is relatively fit and very healthy and not that old. I ended up jumping off the treadmill when it went faster than my legs could walk. I could have run, but I don’t run unless something is chasing me and that NEVER happens 🙂 The results were that my heart kept its delta wave, no matter what. No surprises, there.

After that, I was put on the waiting list at the Big Hospital for an Electrophysiology Precedure and Ablation.

In the next post, I will share the story of my successful ablation procedure.

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