Do You Need Ablation for WPW Syndrome? Can You Fly?

Does Wolff-Parkinson-White (WPW) syndrome require catheter ablation (can I fly)?

Hello, Director.
I am the inquirer regarding WPW syndrome (#198260) and whether I need catheter ablation (and if I can fly).
Thank you very much for your thoughtful response.
After reading your reply, I would like to ask you a few more questions (thank you very much):
1.
Regarding my WPW, I have seen descriptions online from others with WPW who have experienced episodes with heart rates consistently above 150-200 bpm and often needing to go to the emergency room.
Reflecting on my own experience at 48 years old, I believe I have never had similar episodes.
Since my diagnosis at the end of October last year, I have frequently experienced palpitations.
I haven’t visited a cardiologist recently because I am concerned about undergoing the tests I previously showed you.
After being informed of my diagnosis and researching online, I understand that if an episode occurs, it can be dangerous.
If, as you mentioned, I have never had an episode, can I fly in the short term before I have time for the ablation? I am also worried about whether the COVID virus could affect the accessory pathway, and as I age, I wonder if there is an increased risk with that pathway.
2.
Can WPW symptoms evolve into atrial fibrillation, ventricular fibrillation, or other cardiovascular issues?
3.
Regarding catheter ablation, I have consulted with the doctor who examined me and researched online.
The doctor has differing opinions on whether I should undergo ablation, ultimately leaving the decision to me.
However, since it is an invasive procedure, my family hopes I will avoid it due to the inherent risks, even though I have informed them that the success rates are generally between 95-99%.
I am currently quite hesitant.
Based on what you know, is the prognosis after ablation generally good?
4.
Due to my palpitations, I have avoided alcohol since the end of last year (and have reduced my coffee intake).
However, sometimes work-related social events require it.
Before experiencing palpitations, I would drink, but I never exceeded one 250ml bottle of beer per day.
Is this acceptable? Or is it better for someone with WPW to avoid alcohol altogether?
5.
Currently, I ride a stationary bike twice a week for about an hour each time, with my heart rate reaching a maximum of 182 bpm during exercise.
Is this too high? I do not feel any discomfort, but I am concerned whether high-intensity exercise could trigger WPW.
Thank you very much, Director, for your clarification.

Zhang Xiaojie, 40~49 year old female. Ask Date: 2023/07/17

Dr. He Dongjin reply Cardiology

Hello, since you have never experienced anything like this before, just continue living your life as you did in the past! You should fly, exercise, and do whatever you used to do.
If you have been doing well until now, why change your life just because you learned about this condition? After all, you have never had an episode, so continue living your life as you did before.
Why can't you fly?
2.
Wolff-Parkinson-White (WPW) syndrome is not likely to progress to atrial fibrillation, ventricular fibrillation, or cause other cardiovascular issues, so don’t scare yourself unnecessarily.
3.
With the current level of medical care, the prognosis after ablation is generally good.
4.
You can do whatever you want.
If something makes you uncomfortable, then avoid it.
Drink beer, exercise, and do spinning as you wish.
You're still young; don’t turn your life into black and white! Since you have never had an episode, you can actually just observe the situation.
There's no need to rush into an ablation! However, if you spend all day worrying and fearing an episode, avoiding flying, intense exercise, or even having a drink...
doesn’t that make life dull? So, go ahead and consider the ablation; whatever you choose, just make sure to live comfortably.
Life shouldn’t be black and white.
Take care from Changhua Hospital!

Reply Date: 2023/07/17

More Info

WPW syndrome, or Wolff-Parkinson-White syndrome, is a condition characterized by an extra electrical pathway in the heart, which can lead to episodes of rapid heart rate (tachycardia). Your concerns about whether you need ablation, if you can fly, and how to manage your lifestyle are valid and deserve careful consideration.

1. Do You Need Ablation?
Ablation is a procedure that can effectively treat WPW syndrome, especially if you experience frequent episodes of tachycardia. However, since you mentioned that you have not experienced significant episodes of rapid heart rate (150-200 bpm) and have not required emergency care, the decision to undergo ablation may not be urgent. Many patients with WPW live normal lives without needing the procedure, especially if they do not have recurrent symptoms. It’s essential to have a thorough discussion with your cardiologist about your specific case, weighing the risks and benefits of the procedure against your current health status and lifestyle.

2. Can You Fly?
Flying is generally considered safe for individuals with WPW syndrome, particularly if you have not experienced significant symptoms. The fear of potential complications, such as the impact of COVID-19 on your heart, is understandable, but there is no direct evidence suggesting that the virus affects the electrical pathways associated with WPW. If you feel well and have no recent episodes of tachycardia, you should be able to travel without concern. However, it’s always wise to consult your healthcare provider before making travel plans, especially if you have any underlying health concerns.

3. Risk of Progression to Other Heart Issues
While WPW syndrome can lead to other arrhythmias, such as atrial fibrillation or ventricular fibrillation, this is not common in individuals who do not experience frequent episodes of tachycardia. Regular monitoring and follow-up with your cardiologist can help manage any potential risks. It’s important to stay informed about your condition and report any new symptoms, such as increased frequency of palpitations or dizziness.

4. Lifestyle Considerations: Alcohol and Caffeine
Regarding alcohol consumption, moderation is key. If you have been avoiding alcohol due to concerns about heart palpitations, it may be wise to continue limiting your intake, especially if you notice that alcohol triggers your symptoms. A small amount, such as a 250ml beer, may be acceptable for some individuals, but it’s best to listen to your body and avoid substances that exacerbate your symptoms. Caffeine can also be a trigger for some people with arrhythmias, so reducing your intake may be beneficial.

5. Exercise and Heart Rate
Your current exercise routine, including cycling with a maximum heart rate of 182 bpm, is commendable, especially if you feel comfortable and do not experience any adverse symptoms. Regular exercise is generally encouraged for heart health, but it’s crucial to monitor how your body responds. If you ever feel dizzy, faint, or experience palpitations during exercise, it’s advisable to stop and consult your doctor. High-intensity workouts can sometimes provoke arrhythmias, but many individuals with WPW can engage in vigorous exercise without issues.

In summary, while ablation can be an effective treatment for WPW syndrome, it may not be necessary if you are asymptomatic. Flying is typically safe, and lifestyle modifications regarding alcohol and exercise should be tailored to your individual tolerance and symptoms. Regular follow-ups with your healthcare provider will help ensure that you manage your condition effectively and maintain a good quality of life. Always prioritize open communication with your medical team to address any concerns and make informed decisions about your health.

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