Antipsychotics for patients with Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White syndrome (WPW) is a cardiac conduction abnormality characterized by ventricular contractions that appear sooner than the usual interval regulated by the atrioventricular (AV) node. It is commonly asymptomatic but in rare cases can lead to sudden cardiac death. Little is known about the cardiac effects of antipsychotics on patients with WPW. Here we review all the published information currently available on the use of neuroleptics in patients with this cardiac conduction anomaly. Only a few case reports and one controlled study have been published in this area. The limited existing information suggests patients with WPW may be at higher risk for QTc prolongation when exposed to antipsychotics. It also indicates aripiprazole and droperidol could be potential alternatives but more research on this subject is clearly necessary.