The two complications of WPW are the development of an AV re-entrant tachycardia or atrial fibrillation.
An AV re-entrant tachycardia is managed as for any other supraventricular tachycardia (see linked item).
Atrial fibrillation secondary to WPW should not be treated with AV-blocking drugs such as verapamil and digoxin. The simplest method of terminating atrial fibrillation is cardioversion. If drugs are to be used then they must slow conduction in the accessory pathway e.g. intravenous sotalol, flecainide, amiodarone. These drugs will slow the ventricular response and will often result in restoration of sinus rhythm.
For prevention of atrial fibrillation drugs such as oral sotalol and amiodarone are effective.
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