Incidental identification of WPW on electrocardiogram requires assessment of possible symptoms. If the patient is asymptomatic having never had palpitations or syncope, no further specific treatment is required. It is important, however, to remind the patient that they should not take digoxin or verapamil. If the individual is a pilot or makes his living by driving a vehicle, one may be concerned with the possibility of development of atrial fibrillation. It is suggested in these asymptomatic individuals that electro-physiological studies be performed to determine whether there is a short accessory pathway, which is more likely to predispose to atrial fibrillation. If that were the case, then the recommended treatment would be radiofrequency ablation of the accessory pathway. Individuals with documented preexcitation and symptoms should be considered for curative therapy, namely, ablation. If ablation is not considered, then drug therapy such as beta-blockers, amiodarone, or flecainide should be considered. In the familial form of WPW, there is also a conduction defect in the regular normal AV node system and a pacemaker is frequently required for complete heart block. Patients presenting with supraventricular tachycardia should be converted with i.v. adenosine, as seldom it is necessary to perform electrocardioversion.

Getting Started With Dumbbells

Getting Started With Dumbbells

The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.

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