Wolff-Parkinson-White syndrome

Have a friend who's young 18 year old daughter was diagnosed with WPWS. What's is the best line of treatment for this particular heart issue? Does Dr. Natale treat this disease? If not is there a top tier Dr who does?
My advice to them was not to let convenience make any decisions for you.

Thanks!!!!

Ablation is the only realistic long-term treatment for WPWS. Antiarrhythmics can be used just like with afib, but who's going to put an 18-year old girl on amiodarone, flecainide, etc. as a long-term solution? She could potentially live another 80+ years! Does Natale handle WPW cases? I'm sure he does. He's an EP, and treating WPW is in any EP's arena, but I doubt she specifically needs Natale. He's the maestro of afib ablations, but afib ablations are the most difficult and nuanced of all the atrial ablations; everything else pales in comparison. But does he do more WPW ablations than the top EP in their area? I don't know, maybe not. So I would expect that any EP with extensive experience ablating WPW at a major center can handle the case equally well.

I don't know where your friends live, but if they're within reach of a large city with major medical centers, I would recommend investigating those places first. They want an EP with specific, long-term experience ablating (not just treating) WPW, and they want it to be at a major medical center that does this procedure day in and day out.

PS- I liked your advice "not to let convenience make any decisions for you." Good way of putting it.

What Carey said.

I know a number of people with WPW. One, now about 70 got a successful ablation ~15 or so years ago at a local community hospital. I'd have never let the guy touch me for afib, but worked for WPW. I also know a number of people in their 30's that got successfully ablated in their teens or 20's. One of those was ablated at Cleveland Clinic.

My 70 year old friend was told before her ablation that going into the backcountry was risky as the WPW could lead to a ventricular arrhythmia. I think WPW is generally hereditary. Her mom also had it. Even after the ablation, she would have frequent (bigeminal) PAC's at her top end exertion. They were frequent enough to be limiting. These PAC's were exacerbated by high carb consumption and limited with a keto diet. Her story is described here [www.afibbers.org] . These PAC's have been a lifelong issue, not something that happened after the ablation - not sure if they are related to the WPW.

Appreciate the guidance you guys! As can be expected their pretty scared as I'm sure we all were in the beginning. Their located 40 miles from Seattle. I told them last night they need to see an EP or 2 or 3! Regular cardiologists is fine to have but they need and expert on this. Also reiterated to not let convenience make any decisions for them in treating this.

Quote
Kleinkp
Appreciate the guidance you guys! As can be expected their pretty scared as I'm sure we all were in the beginning. Their located 40 miles from Seattle. I told them last night they need to see an EP or 2 or 3! Regular cardiologists is fine to have but they need and expert on this. Also reiterated to not let convenience make any decisions for them in treating this.

My understanding of WPW is that there are one or more extra pathways in the AV node. These pathways are also bi-directional (the normal singular pathway through the AV node from atria to ventricles is only one way, from atria to ventricles). This bi-directionality allows the ventricular signal to be sent back up to the atria and really fast rates can result. The ablation is to kill the extra pathways (NOT the AV node) and my understanding is this is a relatively simple procedure. Aa Carey said, I'd highly recommend an ablation and from a high volume center.

Quote
GeorgeN
I think WPW is generally hereditary.

Yeah, you’re born with it. You can’t “get it” later in life.

So don’t worry, AF folks, that your fibrillating atria are going to spontaneously develop some short-circuit to your ventricles and kill you on the spot. Ain’t gonna happen.

funny I was just looking up the bio on my EP who I love. and it mentioned this syndrome as a speciality for him. (It didn't for others I was looking up...). I don't know any more about this other than I really do like my EP.

[www.uofmhealth.org]

The team at UM does use PAs and NPs but initial appointments are with the doctor. If you are near MI maybe you could- or if you have records etc.. you do maybe do a virtual. I would guess they are scheduling months and months out.