WPW?

PIG Meeting: 22nd April 2021

53-year-old lady for meniscal repair

Background:

  • History of open cardiac procedure/ablation in early 20’s for arrhythmia.
  • No medical records and patient uncertain of cardiac history
  • Sternotomy scar

Issues:

  • Recent new onset palpitations with presyncope
  • No cardiologist or GP review
  • Complex social history and knee injury making it difficult for patient to attend appointments
  • Difficult to ascertain history

Discussion:

1. Cause of original arrhythmia

  • Likely condition requiring ablation in age group is Wolff-Parkinson-white
  • Some suggestion of WPW in old notes on DMR
  • Could be any number of other conditions requiring ablation, SVT, AF

2. Management of current symptoms

  • ECGs from consult and 2019 reviewed (see below) and discussed – ? pre-excitation
  • How likely are arrhythmias to recur post-ablation or is it a second pathology? See abstract below – BMJ open (2019) – Discussion of recurrence rates after EP ablation and risk factors

Plan:

  • Await Holter monitor results
  • Contact GP for further information on original procedure
  • Discuss at cardiology meeting or refer to cardiologist with Holter results.

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