As previously stated, short-term management of supraventricular tachycardia (SVT) involves intravenous adenosine or calcium channel blockers. In cases of wide-complex tachycardia, hemodynamically stable patients can be treated with intravenous procainamide, propafenone, or flecainide.
Is adenosine contraindicated for WPW?
In the presence of WPW, traditional treatments may be contraindicated. Any AV nodal slowing agent, including adenosine, diltiazem and amiodarone, may cause an adverse reaction in the presence of WPW. Of those three medications, AHA recommends amiodarone.
What drug is contraindicated in WPW?
AV node blockers should be avoided in atrial fibrillation and atrial flutter with Wolff Parkinson White syndrome (WPW). In particular, avoid adenosine, diltiazem, verapamil, and other calcium channel blockers and beta-blockers.
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.
What drugs are safe in WPW?
Safe practice in SVT with WPWArrhythmiaDrugs contraindicatedDrugs RecommendedAntidromic AVRTAdenosine Verapamil Diltiazem β-blockers DigoxinProcainamide Flecainide Propafenone AmiodaroneAFAdenosine Verapamil Diltiazem ß-blockers DigoxinProcainamide Ibutilide Dofelitide Flecainide Amiodarone1 more row•Feb 23, 2021
When is adenosine contraindicated?
Adenosine is contraindicated in patients with sinus node disease, such as sick sinus syndrome or symptomatic bradycardia, and in patients with second- or third-degree AV block, except in patients with a functioning artificial pacemaker.
How do you treat SVT in WPW?
Beta-blockers are probably the medications most commonly used to treat SVT in the presence of preexcitation. They are moderately effective and have frequent, but rarely life-threatening, adverse effects (except in the presence of reactive airway disease).
What is the antiarrhythmic for WPW?
Procainamide, a class 1A antiarrhythmic, increases effective refractory period and reduces impulse conduction velocity and excitability in the atria, His-Purkinje fibers, ventricular muscle, and the AP of the heart.
Are beta-blockers contraindicated in WPW?
Verapamil and betablockers are not the drugs to fear upon in WPW syndrome.In fact , even in this era of hi tech cardiac care , it has a useful role to play in the chronic management of WPW .
What is the difference between SVT and Wolff Parkinson White?
What is SVT? Supraventricular tachycardia (SVT) refers to a group of abnormal fast heart rhythms that arise because of a problem involving the upper chambers of the heart. WPW is short for Wolf-Parkinson White syndrome which is a special form of SVT.
Are beta-blockers contraindicated in WPW?
Verapamil and betablockers are not the drugs to fear upon in WPW syndrome.In fact , even in this era of hi tech cardiac care , it has a useful role to play in the chronic management of WPW .
Can beta-blockers be used in WPW?
Beta blocker is also considered in pa- tients with arrhythmia related to an accessory pathway with a short refractory period. So, concomitant admin- istration of beta blocker and flecainide results in great- er long-term efficacy and can be one of options for the treatment of a patients with AF in WPW syndrome [9].
Why is amiodarone contraindicated in WPW?
The use of amiodarone for pre-excited atrial fibrillation (AF) with Wolff-Parkinson-White (WPW) syndrome has been reported to lead to spontaneous ventricular fibrillation.
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.