What is the drug of choice for WPW?
The drug of choice for the treatment of regular supraventricular (reciprocating) tachycardia with narrow QRS complexes, which is the most common arrhythmia in the WPW syndrome, is propranolol. Digitalis is almost equally effective in this case.
What is the best treatment for Wolff Parkinson White Syndrome?
Radiofrequency ablation — Radiofrequency ablation of the accessory pathway is the treatment of choice for patients with WPW syndrome. Radiofrequency ablation is performed in a hospital electrophysiology lab. The patient is given a sedative medication to reduce discomfort.
What is WPW and how is it treated?
Thin, flexible tubes (catheters) are threaded through blood vessels to your heart. Electrodes at the catheter tips are heated to destroy (ablate) the extra electrical pathway causing your condition. Radiofrequency ablation permanently corrects the heart-rhythm problems in most people with WPW syndrome.
How is WPW EMS treated?
WPW with orthodromic AVRT looks identical to run-of-the-mill paroxysmal supraventricular tachycardia (SVT) and can be treated as such. Vagal maneuvers or AV nodal blocking agents are the treatment of choice, as they slow conduction through the AV node and disrupt the re-entrant circuit.
Which drugs are contraindicated in WPW syndrome?
Safe practice in SVT with WPW
| Arrhythmia | Drugs contraindicated | Drugs Recommended |
|---|---|---|
| Antidromic AVRT | Adenosine Verapamil Diltiazem β-blockers Digoxin | Procainamide Flecainide Propafenone Amiodarone |
| AF | Adenosine Verapamil Diltiazem ß-blockers Digoxin | Procainamide Ibutilide Dofelitide Flecainide Amiodarone |
Why is Cardizem contraindicated in WPW?
Diltiazem should be avoided in the presence of pre-excited AF with RVR, that is, AF in the presence of accessory pathway, i.e. Wolff Parkinson White (WPW) syndrome, as AVN blockage can lead to increased conduction through the accessory pathway, leading to life-threatening rapid ventricular rates.
What medications should be avoided with Wolff-Parkinson-White Syndrome?
In particular, avoid adenosine, diltiazem, verapamil, and other calcium-channel blockers and beta-blockers. They can exacerbate the syndrome by blocking the heart’s normal electrical pathway and facilitating antegrade conduction via the accessory pathway [2, 5].
Can amiodarone be used for WPW?
The effect of amiodarone in prolonging the refractory period of the accessory pathway makes this drug especially useful in patients with the Wolff-Parkinson-White syndrome and atrial fibrillation.
What drugs are contraindicated in WPW?
How do you treat pre excitation syndrome?
There are both invasive and non-invasive methods of diagnosing preexcitation syndromes. Therapeutic treatment includes pharmacotherapy and ablation, which makes it possible to permanently remove the cause of the arrhythmia.
Why is procainamide used in WPW?
The use of intravenous procainamide is a reliable and rapid method of identifying patients with the Wolff-Parkinson-White syndrome who may be at risk for circulatory insufficiency or sudden death in case of atrial fibrillation.
Why is amiodarone contraindicated in WPW?
Because amiodarone is a unique multichannel blocker, it potentially affects the atrioventricular nodal conduction rather than the accessory pathway conduction; therefore, the current guidelines do not recommend its use.
How is WPW syndrome associated with an accessory pathway?
WPW syndrome results from tachycardia associated with an accessory pathway. The WPW pattern is diagnosed by a delta wave and/or short PR interval on an ECG. Once symptomatic, patients can be treated with catheter ablation or can try medications to control their symptoms.
What causes the WPW pattern in an ECG?
In some settings, this pathway can result in the transmission of abnormal electrical impulses leading to malignant tachyarrhythmias. The ECG findings of the WPW pattern are caused by the fusion of ventricular preexcitation through the accessory pathway and normal electrical conduction.
What are the treatment options for WPW syndrome?
Symptomatic patients usually undergo catheter ablation as a first-line therapy. Anti-arrhythmic drugs are one of the therapeutic options for the management of symptomatic WPW syndrome, but they have been increasingly replaced by catheter ablation.
What does WPW stand for in medical category?
The term Wolff-Parkinson-White (WPW) syndrome is used to refer to the combination of supraventricular arrhythmias and an electrocardiographic pattern of preexcitation.
