question_ WPW Syndrome and Verapamil
a patient is admitted to hospital with the diagnosis r/o wpw. after aggressive work up, he was discharged on verapamil.
explain this scenario.
with administration verapamil in wpw patient his condition will be worse because calcium chanel blockers slow AV conduction so they are contraindicated in wpw...
drugs of choice for treatment of wpw :class 1A or C antiarrhythmic drugs
What happens in WPW is that there is an alternative (aka accessory) pathway for electrical conduction - not just the AV node. This causes the ventricles to contract more often than they should leading to tachyarrythmias... To treat this, you want to slow down the rhythm or stabilize it some other way until you can find and destroy the accessory pathway using catheter ablation. If you use CCBs in this scenario - you're going to let the conduction from the atria to the ventricle occur in every pathway *except* through the AV node. So, you dont do that....
Acutely, people with WPW who are experiencing tachyarrhythmias may require electrical cardioversion if their condition is critical, or, if more stable, medical treatment may be used.
in this scenario, the diagnosis is r/o wpw. the patient is admitted, got electrophysiology studies done, wpw RULED OUT, and placed on verapamil.
i am learning a lot from you guys, thanks a million
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