The drug of choice in patients with Wolff-ParkinsonWhite syndrome with atrial fibrillation is?
Correct Answer: Procainamide
Description: Answer is B (Procainamide) Intravenous Procainamide is recommended to restore sinus rhythm in patients with Atrial fibrillation associated with the WPW syndrome. Procammide is the single best answer amongst the options provided. Management of Atrial fibrillation with WPW Preexcitation Syndrome: Recommendations 1. Catheter ablation of the accessory pathway is recommended in symptomatic patients with AF who have WPW syndrome, paicularly those with syncope due to rapid hea rate or those with a sho bypass tract refractory period. 2. Immediate direct-current cardioversion is recommended to prevent ventricular fibrillation in patients with a sho anterograde bypass tract refractory period in whom AF occurs with a rapid ventricular response associated with hemodynamic instability. 3. Intravenous procainamide or ibutilide is recommended to restore sinus rhythm in patients with WPW in whom AF occurs without hemodynamic instability in association with a wide QRS complex on the electrocardiogram (ECG) (greater than or equal to 120-ms duration) or with a rapid preexcited ventricular response.
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