The Living Guidelines: Patients with Wolff Parkinson White syndrome (WPW): Suggest Revisions to the CLASS I Guidelines

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Class I Guidelines

  1. Catheter ablation of the accessory pathway is recommended in symptomatic patients with AF who have WPW syndrome, particularly those with syncope due to rapid heart rate or those with a short bypass tract refractory period. (Level of Evidence: B) [1]
  2. Immediate direct-current cardioversion is recommended to prevent ventricular fibrillation in patients with a short anterograde bypass tract refractory period in whom AF occurs with a rapid ventricular response associated with hemodynamic instability. (Level of Evidence: B) [1]
  3. Intravenous procainamide or ibutilide is recommended to restore sinus rhythm in patients with WPW syndrome in whom AF occurs without hemodynamic instability in association with a wide QRS complex on the ECG (greater than or equal to 120-ms duration) or with a rapid pre-excited ventricular response. (Level of Evidence: C) [1]

References

  1. 1.0 1.1 1.2 Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation- Executive Summary: executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidlines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006; 114: 700-752. PMID 16908781

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