Treatment of WPW Syndrome Presenting as Pre-Excited Atrial Fibrillation in a Haemodynamically Stable Patient
Wolff-Parkinson-White syndrome presenting as pre-excited atrial fibrillation requires a targeted approach that differs meaningfully depending on the patient's haemodynamic status. In the stable patient, a structured sequence of interventions applies.
Clinical scenario: Pre-excited atrial fibrillation in a haemodynamically stable patient — no signs of haemodynamic instability are present.
Management approach
For this scenario, the protocol involves an electrical cardioversion-based strategy as part of the management pathway. The complete structured regimen — including the full decision sequence and selection criteria — is available in the protocol below.
References
DOI: 10.1093/eurheartj/ehz467
- Ibutilide or procainamide (i.v.) should be considered.
- Flecainide or propafenone (i.v.) may be considered.
- Synchronized DC cardioversion is recommended if drug therapy fails to convert or control the tachycardia.
View source ↗