Adenosine Testing for WPW Syndrome - a personal experience for information

[Tractorman]

Hi, I've only just found out that the AA had a community - I've been a member of the AF Forum and been posting on here up to now but I'm not sure which is a better place for people interested in Wolff-Parkinson-White Syndrome - so I'll put in on both.

I'm not sure if Healthunlocked is international or not. I, and most of the other people who post seem to be living in the UK and I should start this post by saying that this is my experience of the UK NHS system in dealing with this and if you live elsewhere, this may or may not have some similarity for things where you live. Another caveat - this is MY experience and we are all individuals who will have different experiences depending on a number of factors including but not exclusively, their gender, previous and current health issues and unfortunately, even where they live in the UK. So, for the record, I'm male, aged 62 and previously in good health apart from high blood pressure controlled with medication. I've not been to hospital since I was five years old!

The reason I'm writing this is that when I first found out I was to be tested for WPW by an Adenosine Provokation Test, I searched the net - desperate for any info over and above that which my Cardiologist gave me verbally when I got a rare face to face with him four months prior to actually getting it. I found very little - apart from a .pdf file from the Arrhythmia Alliance called "TESTING USING DRUG-INJECTIONS TO INVESTIGATE THE POSSIBILITY OF A RISK OF SUDDEN CARDIAC DEATH" which you can find here:

aral.org.uk/app/webroot/fil...

Lots of useful info there and as far as I can tell it's the only thing that tells you anything practical. However as there seems to be so little info about this procedure (my NHS Trust has nothing on Adenosine testing) I thought it might be useful to document my experience. I live in Wiltshire and I'm under a Cardiologist in Bath's Royal United Hospital which is where the test was done.

I should say that I do have a phobia about medical procedures generally which drove me to find out as much as possible about what was going to happen to me so this added to my stress levels which had increased over the four months - yes, FOUR months - between the time I was told I needed to have a test and actually getting it. Despite some badgering from my end, I'm pretty sure I got lost in the system as talking to the other people in the waiting area at the hospital it was clear that they were being referred within weeks - one young mum got her appointment within a week.

This had all been brought on by a single instance of dizziness causing me to end up on the floor seeing double about six months previous. I didn't pass out but it was a close thing. My wife took me to A&E and despite keeping me in for eight hours they couldn't find anything wrong. Prior to the Adenosine test, I have had loads of ECGs', X-rays, a Doppler (echo) test, a CT brain scan, a 24 Cardio Monitor, and a treadmill stress test. Nothing was conclusive but my Cardiologist remained convinced I had WPW - and he turned out to be right!

So, having finally got a date for the test, I had to go to my surgery for blood tests and MRSA swabs a week in advance of the admission date. My appointment letter told be that I should arrive at 12:00 and I would be discharged at approx 17:00 - this turned out to be accurate within two minutes! They also stated that the procedure might be cancelled if there were emergency admissions. I was lucky as the person who came in after me got sent home due to lack of bed space so be aware that this could happen to you! The AA document says that you are encouraged to bring someone for support (the missus came with me) but be aware that the procedure area is sterile and they won't be allowed to go with you whilst the test is being administered.

I waited two and a half hours to be seen. All the other people in the room got treated before me - I guess that was as they were having Ajamaline tests which take a lot longer (you get monitored for hours) so I guess there was some logic being deployed somewhere!

When I did get attended to it was to have my cannular inserted in my right arm (through which the Adenosine is introduced into the blood stream). I said that I'd had no info in advance and the nurse said that it was because they didn't do many Adenosine Tests. When the next nurse came to take me to the treatment area (a very nervous 30 minutes later) the first thing she told me was to feel reassured that they were well versed in the procedure and it was pretty much routine for them - so someone was being economical with the truth!

She was to stay with me the whole time and, like all the staff, they were great. Very sympathetic and very professional at all times. They were obviously aware how stressed out I'd become and dealt with me brilliantly. I got changed into a hospital gown and had the ECG fitted within about 15 mins of arriving on the ward. They told me how the test would be done which was pretty much in line with what is in the download so I won't dwell on that too long except to say that there can be up to three seperate tests, each one with an increasing dose of Adenosine. I had the lot - a 6 ml dose, then a 12 ml dose and finally a 24 ml dose. Basically this was because the first two tests didn't give them a clear result on the ECG. The guy in the next bed olny had the first two because it was apparent that he was clear - unlike myself who tested positive.

A word or two about the effects of Adenosine and PLEASE bear in mind that everyone reacts differently. You get told that you may get side effects and from my observations around the ward I think its true that you WILL get side effects. They may include dizziness (not me) tight chestedness (a little), sweating (a lot) and a "strange feeling" (lots). It's almost impossible to describe it so I won't - suffice to say that it wasn't terribly pleasant BUT it goes away very quickly (seconds). But as the doses increase, so do the effects. The first 6 ml dose I hardly noticed. The last one was pretty dramatic. The nurses are there for you all the time and it's all over and done with pretty quickly thank heavens.

After its all done, they give you about an hour to recover - I had to stay in the treatment ward as there was no room in the recovery area at all. I had hoped to talk to my Cardiologist as to where I go from here (pretty obviously ablation) but he was tied up elsewhere so that'll be a follow up appointment. I've been given Bisoprolol (beta-blocker) 2.5 mg to take in the meantime. Quite frankly I've been feeling great up to now so I'm not sure I want to take them but that's another subject.

I left the hospital with my wife at more or less dead on when they predicted but a word of warning - don't drive. I've had my license revoked but the guy in the next bed had driven there and they made him get his wife to come and pick him up. It's quite a shock to the system and you don't realise how much it takes out of you until later.

So that's it - unspectacular and not particularly something to look forward to but nothing to get stressed about either. I hope that if you came looking for this sort of info that you found it useful and you get treated successfully.