Connect
Should beta blockers be used if you have Wolff Parkinson White?
Hello! I am 42 years old. I have had tachycardia my entire life, diagnosed with POTS in 2013, with pre-excitation in 2019 after my daughter was born, and with WPW in 2020.
I underwent an ablation in 2023 and assumed the WPW no longer existed. The physician did not do much follow-up, and when I asked about abnormal EKGs, they downplayed the significance.
I was put on a beta blocker for the continued tachycardia and POTS. A couple of weeks ago, I had two EKGs that clearly showed delta waves and T-wave inversion. Again, I was told not to worry. However, I assume the ablation did not work, or I have additional accessory pathways.
The information on using beta blockers in WPW conflicts, with some stating they should not be used due to being AV Node Blockers and others stating it is fine to use them.
I am looking for feedback and/or clarification. Thank you!
Like
Helpful
HugInterested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.
Connect
This article is dated, but I can't find much that is both more recent and that disputes what is stated below:
https://www.ajconline.org/article/0002-9149(87)90708-9/abstract
But, I did find this one that agrees with your sources and impression:
https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/
It seems that flecainide, Sotalol, propafenone, or amiodarone (a last resort drug, very powerful, rather toxic long-term) are what are usually prescribed, they being anti-arrhythmic drugs. Tikosyn is not listed, another anti-arrhythmic drug, nor is Multaq.
The treatment really depends on what the underlying condition is and none of us has enough information to answer that question. For example your ECG change could reflect a fasciculo ventricular pathway which would not carry a risk of tachycardia or a residual or second anterograde conducting pathway which may or may not be amenable to a repeat ablation. In my humble opinion the best approach would be to see a qualified Electrophysiologist who could review all of your tracings and your medical history and examine you and help you make a decision regarding the best pathway forward. An electrophysiologist is a cardiologist who has additional specialized training to take care of heart rhythm disorders.
Thank you for your response. I have been seeing an electrophysiologist for over 3 years now (and have seen others at Cleveland Clinic, Duke, and UNC) and a cardiologist since 2013, and I still do not have a confirmed diagnosis. An electrophysiologist did the ablation in 2023.
I had not heard of the fasciculo ventricular pathway, so I will look into that. However, I have tachycardia outside the WPW, and no one has determined where it stems from.
Thank you again!
Thank you! I will check out these articles!