Therapy of WPW syndrome

In some patients, an attack can be terminated independently by so-called vagal maneuvers. The patients press in the abdomen or drink a glass of cold water. In some cases, the attacks can be stopped by these maneuvers, but they always return.

Acute drug therapy during the attack can also bring about an end to the attack, but is not a causal treatment. In some patients, attempts are made to establish a prophylactic drug therapy, for example with beta blockers. Other antiarrhythmic drugs can also be used here.

However, the only causal treatment of the disease is radiofrequency catheter ablation. In this type of treatment, a catheter is inserted into the heart via the groin vein – usually as part of the electrophysiological examination. There the accessory pathway is localized and measured.

With the help of electricity, a strong heat is then generated at the tip of the catheter and the scars are placed. This results in an elimination of the affected tissue. The conduction path is thus permanently interrupted.

This therapy is crowned with lasting success in about 90% of cases. Surgery in the true sense of the word is not a therapeutic option in WPW syndrome. Radiofrequency ablation is not an operation but an invasive procedure.

No skin incision is made and no anesthesia is necessary. Drugs from the group of beta-blockers can be used as a therapeutic trial in WPW syndrome. They slow down the transmission of excitation in the area of the AV node. They must be taken permanently for this purpose. However, beta blockers do not always help, so that ablation therapy is often recommended in the course of the disease.

Who does ablation help?

Radiofrequency ablation is the therapy of choice for WPW syndrome. However, a drug therapy can be tried first. However, especially for patients with an increased risk of ventricular fibrillation and sudden cardiac death and for athletes (see below), radiofrequency ablation is recommended as the treatment of choice.

The success rate of the therapeutic procedure is relatively high at around 90%. The procedure itself does not require general anesthesia. In patients with WPW syndrome who have no symptoms, ablation treatment is usually not absolutely necessary.