i am confused--is this wpw or something else--cardiologist not clear

[aylish28]

my cardiologist said i have an extra electrical pathway that is why i get pvc/pac he said i was born with it--he did an av node signal test--to see where it originates or whatever he said all my tests are fine nothing you die off something you die with  but i just read that an extra pathway is wpw is that the case or is it when it is a specific pathway??confused--

[itdood]

WPW is a very specific type of accessory pathway.  There are other accessory pathways that are none-specific, so they aren't WPW.  an accessory pathway is a conducting piece of heart muscle you are born with.  WPW has a very specific and robust pathway between the atria and ventricles.    

I think this question is best answered by your doctor though.  Do you feel comfortable calling the practice and asking them what the proper diagnosis is?  I'd want to know where in the heart it is, how big is it, ...

[PikaPika88]

I have an antegrade accessory pathway.  It is a one way direction from Atrial to Ventricle.  It won't go back up to Atrial.  It also no connection with AV node because my AV node ablated.  I rely on this pathway to send signal to my ventricle.  They also called this WPW pattern.

[PikaPika88]

WPW and SVT both are associated with accessory pathways.  The following is copied and pasted, it was answered by Dr Jeffrey R Boris, M.D at Pediatric Heart forum.

The presence of the extra pathway, also known as an accessory pathway, allows for SVT to occur, as electricity goes down the normal electrical connection (through the A-V node) and back up through the accessory pathway.  Wolff-Parkinson-White syndrome, or WPW, is associated with a certain kind of accessory pathway that allows forward electrical conduction from the atria to the ventricles, with evidence of this seen on the electrocardiogram.  Thus, it is certainly able to cause SVT.  It is associated with greater risk than typical SVT (sometimes also referred to as a "concealed pathway"), as any atrial tachyarrhythmias (fast heart rhythms originating in the atria, such as atrial flutter or fibrillation) can potentially go down this pathway into the ventricles and cause the ventricles to beat so fast as to be incompatible with life.  This causes sudden cardiac death.

[aylish28]

wow thank you so much for that great info!!!!!

[tom_h]

Three different types of tachycardias are associated with accessory pathways.  The most common type results from an electric circuit that travels from the atria through the AV node to the ventricles, then backward through an accessory pathway to the atria, and then back through the same circuit over and over again. Because this is a circuit that reenters itself and involves the atria and ventricles, it is referred to as AV reentrant tachycardia. A less common type of AV reentrant tachycardia involves a circuit that travels forward from the atria through the accessory pathway and backward through the AV node. A third tachycardia that involves accessory pathways is a chaotic irregular beating of the upper chambers of the heart called atrial fibrillation. If a someone with an accessory pathway develops atrial fibrillation and if that particular accessory pathway is capable of rapid electric conduction, this can lead to an extremely rapid pulse rate, which can be dangerous.

WPW syndrome is the combination of accessory pathway activation and episodes of tachycardia. The WPW pattern is diagnosed by a delta wave and/or a short PR interval that can be subtle but can be identified by a specialist. This called a preexcitation or WPW pattern. The presence of a pattern does not necessarily mean that you will experience WPW syndrome.   It can occur at any age, is often first noted in childhood (such as in my case), but may not be diagnosed until adulthood. Symptoms of WPW syndrome are usually abrupt and may include palpitations, chest discomfort, and occasionally fainting.  I an episode this morning just sitting in church when without any warning, BANG!, off it went, 70 to 200 in literally an instant.  WPW can result in sudden cardiac death from the development of a chaotic irregular beating in the upper chambers of the heart called atrial fibrillation with rapid conduction down an accessory pathway leading to an extremely rapid pulse that can lead to cardiac arrest. Fortunately, this is a rare event in patients with WPW, and there are certain factors that can often be identify ahead of time to patients with that risk.

I often get episodes and clusters of PVCs, but the way my EP described it to me was a number of things have to occur at exactly the right moment for tachycardia to occur.  If that criteria isn't met, what results is just a PVC, for me a noticable a bump in my chest.

What I've been noticing for me is I'll begin to get clusters of PCVs for perhaps a couple of days.  This finally results in a bout of tachycardia.  Mine has always been successfully converted by Valsalva, a short breath then bearing down for 5 seconds or so, then releasing to check the rate.  This can be immedately successful, or I may have to try again.  But in 54 years, I've only had to go to the ER one time and once I got there, I fonally converted it on my own.  After the episode, my heart will become quiet for a period of time, perhaps one to two weeks when it will repeat the sequence.

So, after all that wind :) it may be that you're getting these PVC/PAC from an accessory pathway, but all things just aren't dropping into place for tachycardia to occur. Lucky you! :)