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

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.