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‘WPW’ One of Many Causes Of Rapid Heartbeat

Dear Dr. Roach: Can you tell me how the WPW syndrome is detected? My mother had the WPW syndrome, and I think I have it. Sometimes my heart beats fast and wobbly. My whole chest sometimes goes up and down. I went to a cardiologist. My stress test was good. My echocardiogram was good.

Does my heart have to be in the throes of beating off track for the doctor to record and detect WPW syndrome? — T.Y.

Answer: The “WPW” is Wolf-Parkinson-White syndrome, a common (1 in 100) heart condition in which the electrical impulse coming from the heart’s pacemaker in the atria takes an alternate pathway to the ventricles of the heart. Normally, the electrical stimulus travels down a pathway so that it arrives in the ventricle precisely when needed. However, in WPW syndrome, the impulse comes too quickly down the alternate path. Occasionally, this leads to a big problem, because the electrical impulse can travel back up the normal path and down the fast path again, over and over, causing an extremely rapid heart rate.

WPW usually is found on a routine EKG. There are cases where it can’t be seen, in which case a stress test is often diagnostic. But there are more causes for fast heartbeats. Your cardiologist has done both the echo and the stress test. If you keep having symptoms, you could wear a device that records your heartbeats continuously for 24-48 hours, called a Holter monitor, or an event monitor for even longer times. Speak to your cardiologist if you keep having symptoms.

WPW can be treated with medication, but it now is more frequently being treated with radiocatheter ablation, where the extra pathway is destroyed with radio waves. Not everyone with WPW needs treatment.

Dear Dr. Roach: I was wondering what you think about the latest blow against calcium. German and Swiss researchers followed 24,000 adults for 11 years. They found that regular users of calcium supplements had an 86 percent increased risk of heart attack! I’ve been taking vitamin and calcium supplements for years. Should I be concerned? — V.A.

Answer: There have been three papers looking at calcium and heart disease risk published in the past year. Two of them showed no benefit or evidence of harm, and one showed evidence of benefit. I carefully read the German study you cite, and the 86 percent apparent risk almost disappears when you look at the data regarding the cumulative effects of supplementation.

New data always should be reviewed with caution, especially if it overturns accepted scientific wisdom. Once in a while, something really does turn the scientific world on its head, but in this case I don’t think that calcium supplementation is likely to cause a large increase in heart risk.

On the other hand, it isn’t likely to cause a large benefit, either, so consider why you are taking it. For people with osteoporosis, the benefits of taking calcium clearly outweigh the risks. For everyone else, getting all the calcium you need from food isn’t easy, but it may have the best outcome of all.

Dr. Roach regrets that he is unable to answer individual letters but will include them in this column when possible. Email questions to ToYourGoodHealth@med.cornell.edu.