Digoxin, Propranolol, and Atrioventricular Reentrant Tachycardia in the Wolff-Parkinson-White Syndrome

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Abstract
In 22 patients with atrioventricular reentrant tachycardia incorporating a retrogradely conducting accessory pathway, electrophysiologic studies were done before and after oral digoxin, 1.25 mg, and propranolol, 160-240 mg, each given in 4 divided doses at 6-h intervals. Before digoxin and propranolol, all 22 patients had induction of sustained tachycardia. After the medication, 6 patients lost the ability to induce atrial echo and 1 lost the ability to sustain tachycardia due to an increased retrograde accessory pathway and/or atrial refractoriness. Six patients lost the ability to induce or sustain tachycardia due to increased atrioventricular nodal refractoriness. In the remaining 9 patients with inducible sustained tachycardia, cycle lengths of tachycardia were prolonged. Apparently, combined use of oral digoxin and propranolol is useful in selected patients with atrioventricular reentrant tachycardia.