In Wolf-Parkinson-White syndrome complicated by atrial fibrillation, the drug that is absolutely contraindicated due to risk of ventricular fibrillation is:
- A Flecainide
- B Procainamide
- C Digoxin ✓
- D Amiodarone
Correct answer: C. Digoxin
Explanation
In WPW with AF, digoxin (and also verapamil) increases refractoriness of the AV node while paradoxically shortening the refractory period of the accessory pathway, potentially accelerating conduction through the accessory bundle during AF and precipitating ventricular fibrillation. Procainamide prolongs the refractory period of the accessory pathway and is safe/preferred. Flecainide and amiodarone are also used cautiously.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.