Skip to main content
SpringerLink
Log in

Challenging the superiority of amiodarone for rate control in Wolff-Parkinson-White and atrial fibrillation

  • EM - Review
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

The objective of this review is to explore and challenge the superiority of amiodarone for rate control in Wolff-Parkinson-White syndrome and concomitant atrial fibrillation (WPW-AF). The current recommendation for pharmacological treatment of this condition is amiodarone. A review of the past 25 years of literature finds several studies that identify a small risk of ventricular fibrillation secondary to amiodarone administration for rate control in WPW-AF. Additionally, the literature supports the safe and effective use of procainamide for rate control in WPW-AF. This review concludes that amiodarone is not superior to procainamide in rate control for WPW-AF, and may be dangerous.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. AHA (2005) American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 7.3: Management of symptomatic bradycardia and tachycardia. Circ 112:IV-67–IV-77

    Google Scholar 

  2. Boriani G, Biffi M, Frabetti L et al (1996) Ventricular fibrillation after intravenous amiodarone in Wolff-Parkinson-White syndrome with atrial fibrillation. Am Heart J 131:1214–1216

    Article  CAS  PubMed  Google Scholar 

  3. Cummins RO, Hazinski MF (2006) The quest for a terminator. Ann Emerg Med 47:227–229

    Article  PubMed  Google Scholar 

  4. Fengler BT, Brady WJ, Plautz CU (2007) Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. Am J Emerg Med 25:576–583

    Article  PubMed  Google Scholar 

  5. Kappenberger LJ, Fromer MA, Steinbrunn W et al (1984) Efficacy of amiodarone in the Wolff-Parkinson-White syndrome with rapid ventricular response via accessory pathway during atrial fibrillation. Am J Cardiol 54:330–335

    Article  CAS  PubMed  Google Scholar 

  6. Li P (1991) Electrophysiological properties of atrial fibrillation with WPW syndrome and the role of procainamide in conversion. Chin J Cardiovasc Dis 19:65–66 123

    CAS  Google Scholar 

  7. Madrid AH, Moro C, Maŕin Huerta EM et al (1992) Atrial fibrillation in Wolff-Parkinson-White syndrome: reversal of isoproterenol effects by sotalol. Pacing Clin Electrophysiol 15:2111–2115

    Article  CAS  PubMed  Google Scholar 

  8. Marill KA, deSouza IS, Nishijima DK et al (2006) Amiodarone is poorly effective for the acute termination of ventricular tachycardia. Ann Emerg Med 47:217–224

    Article  PubMed  Google Scholar 

  9. Pastor A, Almendral JM, Ormaetxe J et al (1993) Ventricular fibrillation during treatment of atrial fibrillation with intravenous amiodarone in patients with the WPW syndrome [abstract]. Eur Heart J 14(Suppl):294

    Google Scholar 

  10. Prystowsky EN, Benson DW Jr, Fuster V et al (1996) Management of patients with atrial fibrillation. A statement for healthcare professionals. From the subcommittee on electrocardiography and electrophysiology. American Heart Association. Circulation 93:1262–1277

    CAS  PubMed  Google Scholar 

  11. Prystowsky EN, Katz AM (1998) Atrial fibrillation. In: Textbook of cardiovascular medicine. Lippincott-Raven. Philadelphia, Pennsylvania, p 1661

  12. Schatz I, Ordog GJ, Karody R et al (1987) Wolff-Parkinson-White syndrome presenting in atrial fibrillation. Ann Emerg Med 16:574–578

    Article  CAS  PubMed  Google Scholar 

  13. Schützenberger W, Leisch F, Gmeiner R (1987) Enhanced accessory pathway conduction following intravenous amiodarone in atrial fibrillation. A case report. Int J Cardiol 16:93–95

    Article  PubMed  Google Scholar 

  14. Schützenberger W, Leisch F, Kerschner K et al (1989) Clinical efficacy of intravenous amiodarone in the short term treatment of recurrent sustained ventricular tachycardia and ventricular fibrillation. Br Heart J 62:367–371

    Article  PubMed  Google Scholar 

  15. Sheinman BD, Evans T (1982) Acceleration of ventricular rate by fibrillation associated with the Wolff-Parkinson-White syndrome. Br Med J (Clin Res Ed. 1981) 285:999–1000

    Google Scholar 

  16. Tijunelis MA, Herbert ME (2005) Myth: intravenous amiodarone is safe in patients with atrial fibrillation and Wolff-Parkinson-White syndrome in the emergency department. J Canad Assoc Emerg Phys 7:262–265

    Google Scholar 

Download references

Acknowledgments

Special thanks to Dr. Gary Moreau MD, Long Beach Memorial Hospital, for his assistance in medical record retrieval. A special thanks to Ms. June Casey for her assistance in the copy editing of this paper, to Joy Le, Ed Wu, Daniel Chen, and Roger Li for their support in article translations.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. University of California, Irvine School of Medicine, Los Angeles, USA

    Sharis M. Simonian

  2. Department of Emergency Medicine, University of California, Irvine School of Medicine, 101 The City Drive, Rte 128-01, Orange, CA, 92868, USA

    Shahram Lotfipour & Mark I. Langdorf

  3. Emergency Ultrasound, Hennepin County Medical Center, Minneapolis, USA

    Christopher Wall

Authors
  1. Sharis M. Simonian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shahram Lotfipour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christopher Wall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark I. Langdorf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark I. Langdorf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Simonian, S.M., Lotfipour, S., Wall, C. et al. Challenging the superiority of amiodarone for rate control in Wolff-Parkinson-White and atrial fibrillation. Intern Emerg Med 5, 421–426 (2010). https://doi.org/10.1007/s11739-010-0385-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-010-0385-6

Keywords

Search

Navigation