Wolff-Parkinson-White syndrome drug prophylaxis: Difference between revisions

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{{Wolff-Parkinson-White syndrome}}
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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
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==Overview==
Oral [[beta-blocker]], [[diltiazem]], and [[verapamil]] for prevention of [[AVRT]] in patients without preexcitation in resting [[ECG]]. Oral [[flecainide]] and [[propaphenone]] in patients with preexcitation in resting [[ECG]] that are not candidates for catheter ablation and do not have structural or [[ischemic heart disease]].
==Drug Prophylaxis In The Patient With Proven Tachyarrhythmias==
==Drug Prophylaxis In The Patient With Proven Tachyarrhythmias==
# Should receive prophylactic treatment if the arrhythmia is poorly tolerated.
* Oral [[beta-blocker]], [[diltiazem]], and [[verapamil]] for prevention of [[AVRT]] in patients with out preexcitation in resting [[ECG]].
# In Wellen's experience amiodarone is the most effective in preventing attacks of paroxysmal tachycardia in patients with WPW. Otherwise he recommends quinidine, disopyramide, procainamide or propranolol alone or in combination.
* Oral [[flecainide]] and [[propaphenone]] in patients with preexcitation in resting [[ECG]] that are not candidates for catheter ablation and do not have structural or [[ischemic heart disease]].<ref name="PageJoglar2016">{{cite journal|last1=Page|first1=Richard L.|last2=Joglar|first2=José A.|last3=Caldwell|first3=Mary A.|last4=Calkins|first4=Hugh|last5=Conti|first5=Jamie B.|last6=Deal|first6=Barbara J.|last7=Estes III|first7=N.A. Mark|last8=Field|first8=Michael E.|last9=Goldberger|first9=Zachary D.|last10=Hammill|first10=Stephen C.|last11=Indik|first11=Julia H.|last12=Lindsay|first12=Bruce D.|last13=Olshansky|first13=Brian|last14=Russo|first14=Andrea M.|last15=Shen|first15=Win-Kuang|last16=Tracy|first16=Cynthia M.|last17=Al-Khatib|first17=Sana M.|title=2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia|journal=Heart Rhythm|volume=13|issue=4|year=2016|pages=e136–e221|issn=15475271|doi=10.1016/j.hrthm.2015.09.019}}</ref>
# For those patients with life-threatening rates during afib, Wellen's recommends amiodarone as prophylaxis which prolongs the AP refractory period. Quinidine is an alternative, but is less effective.
# These patients should undergo EP studies to assess the adequacy of treatment.
# These authors state that the refractory period of the AP can shorten in the presence of sympathetic stimulation and advocate the addition of a beta blocker.  


==References==
==References==

Latest revision as of 08:57, 12 November 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Zand, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]

Overview

Oral beta-blocker, diltiazem, and verapamil for prevention of AVRT in patients without preexcitation in resting ECG. Oral flecainide and propaphenone in patients with preexcitation in resting ECG that are not candidates for catheter ablation and do not have structural or ischemic heart disease.

Drug Prophylaxis In The Patient With Proven Tachyarrhythmias

References

  1. Page, Richard L.; Joglar, José A.; Caldwell, Mary A.; Calkins, Hugh; Conti, Jamie B.; Deal, Barbara J.; Estes III, N.A. Mark; Field, Michael E.; Goldberger, Zachary D.; Hammill, Stephen C.; Indik, Julia H.; Lindsay, Bruce D.; Olshansky, Brian; Russo, Andrea M.; Shen, Win-Kuang; Tracy, Cynthia M.; Al-Khatib, Sana M. (2016). "2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia". Heart Rhythm. 13 (4): e136–e221. doi:10.1016/j.hrthm.2015.09.019. ISSN 1547-5271.

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