How is hemodynamic instability treated in 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

In patients with a very fast ventricular rate, hemodynamic instability (eg, hypotension, mental status change) may ensue. The initial treatment of choice in such patients is DC synchronized electrical cardioversion, biphasic. The electrical shock depolarizes all excitable myocardium, lengthens refractoriness, interrupts reentrant circuits, discharges foci, and establishes electrical homogeneity that terminates reentry.


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