Cardiology: Wolff–parkinson–white syndrome (wpw) — Closed ablation (laser, rf or catheter). Treatment
WPW syndrome is an inherent feature of the heart conduction system upon which the ventricles are excited ahead. The incidence rate of this anomaly is 0.1 to 3 per 1000 persons. It is diagnosed in men 1.5 times more frequently. To select an adequate treatment method, the patients need to consult a cardiologist-arrhythmologist.
Patients with WPW syndrome, between the atria and ventricles, have additional conductive fibers, in addition to the main ones, which cause premature pulse propagation. These fibers are called the "Kent bundle." Because of the detours in the heart conduction system, the circular excitation waves are formed, provoking the development of arrhythmias.
Patients complain of recurrent bouts of palpitations, arising spontaneously or in the background of increased stress. The frequency of bouts may vary widely, from daily to very rare (occurring 1 to 2 times a year). Often the condition is accompanied by shortness of breath, dizziness, and loss of consciousness.
Increased heart rate to 200-240 beats per minute threatens the ventricle fibrillation (chaotic reduction).
The disease is diagnosed on the basis of complaints and research findings:
- 12-lead ECG,
- 24h ECG monitoring,
When the picture remains unclear, a transesophageal stimulation is conducted. During the procedure, the electrode generating pulses with a certain frequency is fixed in the patient’s esophagus. Depending on the way the heart responds to external stimuli, the availability of additional pathways is detected.
The diagnosis of WPW syndrome is established only when the patient suffers from arrhythmia. Otherwise, the physicians speak about electrocardiographic WPW phenomenon, which does not require treatment.
The most effective treatment method is radiofrequency ablation. Through a special catheter, the surgeon affects the Kent bundle with electric shock, resulting in a blockade of pathological impulses. The procedure is performed under local anesthesia and features a small traumatism to tissues.
If the surgery is not possible, the patients are recommend to take antiarrhythmics. In the event of atrial fibrillation attacks, the physicians resort to electrical cardioversion (i.e. influence the heart with a powerful electric discharge).Hide
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