Which agents are contraindicated in patients with preexcitation syndrome and atrial fibrillation (Afib) (AF)?

Updated: Apr 09, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Extreme care must be taken in patients with preexcitation syndrome and AF. Blocking the AV node in some of these patients may lead to AF impulses that are transmitted exclusively down the accessory pathway, and this can result in ventricular fibrillation. (If this happens, the patient will require immediate defibrillation.) Beta-blockers, non-dihydropyridine calcium channel blockers, digoxin, and intravenous amiodarone are contraindicated in these patients; flecainide or amiodarone can be used instead. [1, 71]


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