Which drugs act on the accessory pathway (AP) in the treatment of Wolff-Parkinson-White (WPW) syndrome?

Updated: Jan 08, 2017
  • Author: Christopher R Ellis, MD, FACC, FHRS; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

Class Ia drugs (eg, quinidine) and class Ic drugs (eg, flecainide, propafenone) slow conduction velocity in the AP and prolong the AP refractory period in the bypass tract.

Amiodarone, dofetilide, and sotalol prolong refractoriness in myocardial tissue, including AV bypass tracts.

Procainamide is no longer available in an oral formulation and is typically only used during EPS or in the emergency department (ED) or cardiac intensive care unit (ICU) setting.


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