Incidence, clinical, electrophysiological characteristics and outcomes of patients with Wolff-Parkinson-White syndrome and atrial fibrillation

Shock first, ask questions later…

“…Most experience mostly orthodromic tachycardias (antegrade conduction via AV node, retrograde conduction via the accessory pathway) -as such, they are protected by the in-built rate control of the AV node and will not have delta waves whilst in a tachycardia. 5 The minority have antidromic conduction (antegrade conduction via the accessory pathway) with only a few having the capability of sufficiently rapid conduction to make 1:1 conduction of fibrillation waves possible -however those that do have a potential risk of AF triggering VF and sudden cardiac death. 4…”

WPW Syndrome: Review of the Evidence

“…Clinical studies show that even after successful APABLATION surgery, the possibility of AF relapse is still present, which in turn depends on independent and non-independent factors [4]. These factors include age and gender or even underlying problems such as genetic factors [3]. These cases also depend on the type and origin of AF and are very decisive [6].…”

“…If adenosine was not responsive to SVT in these conditions, it could be said to be the cause of VF and VF-appropriate treatments should be performed [41]. ADENOSIN should also be used with caution as it may cause side effects and even lead to VF [3].…”

“…Amiodarone: Contraindicated treatment in a number of patients who used amiodarone to prevent VF due to pre-exited AF converted AF to a normal sinus rhythm but in some cases caused hemodynamic instability with VF [3]. There is actually evidence that as long as amiodarone is converted to desethylamiodarone, it can act as a beta-receptor antagonist, blocking the AV node and converting AF to VF, so it cannot be AF as a first-line drug for every patient [58].…”

“…According to experiments and clinical observations, the possibility of AF in people with overt WPW is higher than those with latent WPW [3].…”