Intravenous procainamide is the treatment of choice for patients with Wolff-Parkinson-White syndrome who have a preexcited ventricular response during AF, provided they are hemodynamically stable. Patients who are unstable (eg, those with hypotension or significant heart failure) may require immediate cardioversion.

What is the antiarrhythmic for WPW?

Procainamide, a class 1A antiarrhythmic, increases effective refractory period and reduces impulse conduction velocity and excitability in the atria, His-Purkinje fibers, ventricular muscle, and the AP of the heart.

Are beta blockers safe in WPW?

They are moderately effective and have frequent, but rarely life-threatening, adverse effects (except in the presence of reactive airway disease). Their efficacy in reducing the risk of accelerated conduction of AF in WPW patients is unclear.