An accessory pathway in the heart allows electrical signals to bypass the atrioventricular node, potentially leading to cardiac arrhythmias. Diagnosis can be made through an electrocardiogram, and treatment involves surgical ablation or medication. Patients should discuss risks and treatment options with their healthcare provider.
An accessory pathway is a conductive pathway in the heart that allows electrical signals to pass directly from the atria to the ventricles, rather than being routed through the atrioventricular (AV) node as is the case in healthy individuals. The percentage of people born with an accessory pathway is somewhat unclear, as sometimes it does not cause problems, while in other cases it can lead to the development of cardiac arrhythmias. One condition that can sometimes be seen in patients with an accessory pathway is Wolff-Parkinson-White syndrome.
The accessory pathway can conduct signals very quickly and recover very quickly. It can result in the premature delivery of electrical signals to the ventricles, causing cardiac arrhythmias in which the heart beats abnormally because the cycle of electrical signals is disrupted. Also, arrhythmias that begin in the atria can spread to the ventricles via the accessory pathway when they would normally be limited by the AV node.
A medical study such as an electrocardiogram can be used to identify an arrhythmia. Cardiac arrhythmias have certain signatures that healthcare professionals can use to identify their origins. In the case of a patient with an accessory pathway, if an abnormal electrical signal is detected, the clinician can determine the severity of the abnormality and discuss the risks with the patient. A primary concern is that a patient might have a heart attack due to an arrhythmia.
Treatment for an accessory pathway involves surgical ablation to damage the tissue so it can no longer carry electrical signals. One commonly used technique involves using radio waves to bombard extra tissue in the heart. There are risks associated with ablation procedures and patients should discuss these risks carefully before consenting to surgery. In some cases, medications can also be used to control the electrical rhythms of the heart.
If an accessory pathway is diagnosed, patients may want to ask how serious it is, what the potential complications might be, and if any treatments are recommended. If a treatment is offered, patients can ask how it works, what it is used for, what the alternatives are, and if there are any risks associated with the treatment. It is important to obtain as much information as possible when making medical decisions to make an informed choice possible. Patients may also want information they can use when discussing their options with friends and family, as well as caregivers who can play a role in treatment and recovery.
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