A 28-year-old man with a history of intermittent palpitations presents with lightheadedness. Vital signs: BP 118/76 mmHg, HR 165 bpm, RR 18, temp 37.2°C, SpO2 98% on room air. ECG shows irregular wide-complex tachycardia with varying QRS morphology. Prior ECG in sinus rhythm demonstrated a short PR interval and delta waves. Troponin is normal. He denies chest pain. Which pharmacologic agent is most appropriate for acute rate control in this hemodynamically stable patient?
- A)Verapamil
- B)ProcainamideGABARITO
- C)Adenosine
- D)Digoxin
- E)Metoprolol
Explicação
This patient has atrial fibrillation with preexcitation through an accessory pathway. AV nodal blockers can accelerate conduction down the accessory pathway and precipitate ventricular fibrillation; procainamide is preferred because it slows conduction in the ... Ver explicação completa e trilha adaptativa →