I didn't run into one yet. Definitely something you want to make sure before administering a ccb.
Isn't that only in WPW with AF? I think normal WPW with retrograde conduction, node blockers are safe and effective.
Certainly not something I have experience with, just recalling what I've read.
With an SVT that is actually WPW, how would you know? You wouldn't see a Delta wave with the tachycardia. Adenosine blocks AV node conduction temporarily. I ask whether or not it has an effect on the aberrant pathways associated with WPW.
I think it is still worth looking for delta waves in tachycardia. There is also some question as to whether or not adenosine is safe in WPW either. Most of the research I've found seems to indicate that it is safe however one of the medical directors is staunchly against. Not to mention a patient that we induced V-tach with. She was in a narrow complex SVT at 180 and in retrospect the delta waves were more than visible though I am not sure I would not do the same thing again.
I've had a patient go to vt and self cardiovert to sinus in 2-3 minutes. She didnt feel it at all. But she didnt have a known accesory pathway.
I think CCBs are pretty big no no in Afib WPW. If you block or slow AV nodal conduction, the accessory pathway is going to receive all those impulses and block none of them, which will (as stated) induce VF. Or at least that's how I came to figure it.
