Materiały źródłowe

• #1 Supraventricular tachycardia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/diagnosis-treatment/drc-20355249

  Most people with supraventricular tachycardia (SVT) don’t need treatment. If the very fast heartbeat happens often or lasts for a long time, your care team may suggest treatment. […] Treatment for SVT may include: […] Carotid sinus massage. The carotid arteries are the two main blood vessels that send blood to the head and brain. There is one on each side of the neck. During carotid sinus massage, a healthcare professional gently presses on a specific area of the neck by the carotid artery. This makes the body release chemicals that slow the heart rate. Carotid massage should only be done by an experienced healthcare professional. Do not do carotid sinus massage on your own. […] Vagal maneuvers. Simple but specific actions such as coughing, bearing down as if passing stool or putting an ice pack on the face can help slow down the heart rate. These actions affect the vagus nerve, which helps control the heartbeat.

• #1 SVT: Supraventricular Tachycardia – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/svt-supraventricular-tachycardia/

  The management of SVT differs based on patient stability, patient preference, and the underlying SVT mechanism. The treatments described in the following sections are based on the 2015 American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines for treating SVT. […] Vagal maneuvers, including the Valsalva maneuver and carotid sinus massage, are the first-line interventions for SVT of unknown origin in stable patients. If vagal maneuvers do not terminate the SVT, intravenous (IV) adenosine is recommended. When first-line therapy is ineffective or contraindicated, and the patient is hemodynamically stable, IV beta blockers, IV verapamil, or IV diltiazem are recommended. If after receiving medical therapy patients are still in regular SVT, synchronized cardioversion is recommended. Hemodynamically unstable patients with regular SVT should undergo synchronized cardioversion.

• #1 Diagnosis and Management of Common Types of Supraventricular Tachycardia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html

  The Valsalva maneuver is used for a variety of reasons, including termination of SVT. […] If nonpharmacologic maneuvers are ineffective, pharmacotherapy is the next line of treatment. […] Because of its quick onset, high effectiveness and short half-life (about 10 seconds), adenosine is recommended as the first-line agent. […] In patients with Wolff-Parkinson-White syndrome, adenosine, calcium channel blockers, or digoxin may be used acutely, but they should not be used long-term because these AV nodal blocking agents can force conduction down the accessory pathway, predisposing the patient to ventricular fibrillation. […] If the frequency and intensity of the SVT episodes are severe enough to merit longer-term treatment, management options include pharmacologic treatment or catheter ablation.

• #1 Supraventricular Tachycardia – SVT

  https://aci.health.nsw.gov.au/networks/eci/clinical/tools/cardiology/supraventricular-tachycardia-svt

  The treatment for AVRT and AVNRT is the same for narrow complex tachycardias. Do not use these guidelines for wide complex tachycardias. […] Modified valsalva REVERT trial shows improved response to Valsalva manoeuvers if done sitting, sustained Valsalva for 15 secs(attempt to blow into 10ml syringe), then positioning flat and raising legs for 15 secs. This increased rates of cardioversion from 17% to 40%. […] Carotid sinus massage Patient supine with neck hyperextended, apply gentle pressure for 10-15secs. […] Mainstay of treatment is chemical cardioversion using intravenous Adenosine. This is recommended to be given at increments of 6mg, 12mg and then a further 12mg dose. […] Adenosine has a very short half life (10secs) and should be given via a large vein, ideally in the antecubital fossa. Give as a rapid bolus using a 3 way tap, then a 20mL rapid 0.9% saline flush.

• #1 Supraventricular Tachycardia (SVT): Types, Causes, & Risk Factors

  https://www.webmd.com/heart-disease/atrial-fibrillation/what-is-supraventricular-tachycardia

  SVT Treatment […] Usually, SVT doesn’t require any treatment. If it bothers you, your doctor can choose from among several different treatments. They include: […] A carotid sinus massage is when your doctor rubs your neck along your carotid artery, which causes your heart to slow down. Only experienced professionals should do this. Never try it on your own. […] Sometimes, certain actions can relieve SVT. Try coughing, holding your breath, putting an ice pack on your face, or pushing as if you’re about to poop. These can calm the vagus nerve, which runs from the lower part of your brain through your neck to your stomach and controls your heart rate. Your doctor can show you how to do these maneuvers safely. […] Some medications can help keep your heartbeat under control. If you regularly have episodes of SVT, your doctor might prescribe: Adenosine (Adenocard), Atropine (AtroPen), Beta-blockers, Calcium channel blockers, Digoxin (Digitek), Potassium channel blockers. Follow your doctor’s directions for taking each medication, and talk with them about potential side effects.

• #1 Paroxysmal Supraventricular Tachycardia Treatment & Management: Approach Considerations, Vagal Maneuvers, Short-Term Pharmacologic Management

  https://emedicine.medscape.com/article/156670-treatment

  Guidelines on the management of supraventricular tachycardias (SVTs) are available from the American College of Cardiology/American Heart Association (2015), the European Heart Rhythm Association (2017), the European Society of Cardiology Scientific Group (2017), and the European Society of Cardiology (2019). […] Acute management of paroxysmal SVT includes controlling the rate and preventing hemodynamic collapse. If the patient is hypotensive or unstable, immediate cardioversion with sedation must be performed. If the patient is stable, vagal maneuvers can be used to slow the heart rate and to convert to sinus rhythm. If vagal maneuvers are not successful, adenosine can be used in increasing doses. If adenosine does not work, atrioventricular (AV) nodal blocking agents like calcium channel blockers or beta-blockers should be used, as most patients who present with PSVT have AV nodal reentrant tachycardia (AVNRT) or AV reentrant tachycardia (AVRT). These arrhythmias depend on AV nodal conduction and therefore can be terminated by transiently blocking this conduction.

• #1 Diagnosis and Management of Common Types of Supraventricular Tachycardia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html

  Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. […] Vagal maneuvers may terminate the arrhythmia; if this fails, adenosine is effective in the acute setting. […] Calcium channel blockers (diltiazem or verapamil) or beta blockers (metoprolol) can be used acutely or as long-term therapy. […] Class Ic antiarrhythmics (flecainide or propafenone) can be used long-term. […] Class III antiarrhythmics (amiodarone, sotalol, or dofetilide) are effective, but have potential adverse effects and should be administered in consultation with a cardiologist. […] Catheter ablation has a success rate of 95% and recurrence rate of less than 5%, and causes inadvertent heart block in less than 1% of patients. It is the preferred treatment for symptomatic patients with Wolff-Parkinson-White syndrome.

• #1 Supraventricular tachycardia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/diagnosis-treatment/drc-20355249

  Medicines. If SVT happens frequently, medicines may be given to control the heart rate or reset the heart rhythm. It’s very important to take the medicine exactly as directed in order to reduce complications. […] Cardioversion. Paddles or patches on the chest deliver shocks that reset the heart rhythm. This treatment is generally used when emergency care is needed or when vagal maneuvers and medicines don’t work. It’s also possible to do cardioversion with medicines. […] Catheter ablation. In this treatment, a doctor inserts one or more thin, flexible tubes called catheters through a blood vessel, usually in the groin. Sensors on the tip of the catheter use heat or cold energy to create tiny scars in the heart. The scars block faulty heart signals that cause the irregular heartbeat. […] Pacemaker. Rarely, a small device called a pacemaker is needed to help the heart to beat. It stimulates the heart as needed to keep it beating regularly. A pacemaker is placed under the skin near the collarbone in a minor surgery. Wires connect the device to the heart.

• #1 Treatment

  http://www.cardiosmart.org/topics/supraventricular-tachycardia/treatment

  In most cases, if you experience short episodes of supraventricular tachycardia (SVT) with no symptoms, your health care professional may recommend no therapy. However, if you do have symptoms, frequent episodes, or both, then you will likely require treatment. […] What treatment is best for you depends on the type of SVT you have, how often it occurs, and the degree and length of symptoms. The goal is to prevent these abnormal heart rhythms and to limit your symptoms. […] Your treatment might include: […] Vagal maneuvers: For a sudden episode of SVT, actions such as bearing down, coughing, or holding your breath may stop the abnormal rhythm. These actions can slow the electrical impulses in your heart. […] Medications: Patients may be prescribed daily medications to help prevent SVT episodes from occurring or to slow heart rates during SVT episodes. Commonly prescribed medications are beta-blockers, verapamil, and digoxin. Occasionally, other medications called antiarrhythmic drugs (such as amiodarone or sotalol) may be given to prevent SVT episodes from occurring.

• #1 Supraventricular Tachycardia (SVT) | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/supraventricular-tachycardia-svt

  Treatments for SVT include medications you can take at the onset of symptoms, and vagal maneuvers which allow you to slow your heart rate yourself through coughing, gagging or putting your face in cold water. […] If you cannot resolve the SVT on your own, you may need to see your doctor or go to the ER for a fast-acting medication or even electrical cardioversion, a procedure that uses an electric current to reset the heart’s rhythm. […] To manage SVT on a regular basis there are medicines to slow the heart rate and prevent the onset of SVT. However, for more stubborn cases, there is a procedure called catheter ablation, which destroys the part of the heart that causes the problem. This procedure is the gold standard and has a 99 percent success rate. We do this procedure more than any other ablation. […] There are ways to prevent SVT at home by avoiding certain triggers. Common triggers include alcohol, caffeine, smoking, some over-the-counter decongestants, diet pills, and drugs such as cocaine and methamphetamine.

• #1 Diagnosis and Management of Common Types of Supraventricular Tachycardia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html

  Catheter ablation is an effective first-line treatment option for many patients with AVRT or AVNRT. […] Catheter ablation is the standard of care for older children with symptomatic SVT, although pharmacologic therapy remains the treatment of choice for newborns and infants. […] Catheter ablation has a success rate of 95%, with a recurrence rate of less than 5% and a rate of inadvertent heart block of less than 1%.

• #1 Supraventricular tachycardia – Wikipedia

  https://en.wikipedia.org/wiki/Supraventricular_tachycardia

  Lifestyle changes, medication and heart procedures may be needed to control or eliminate the rapid heartbeats and related symptoms. […] Acute attacks of supraventricular tachycardia are treated with Esmolol (i.v.). […] Radiofrequency ablation has revolutionized the treatment of tachycardia caused by a re-entrant pathway. This is a low-risk procedure that uses a catheter inside the heart to deliver radiofrequency energy to locate and destroy the abnormal electrical pathways. […] Cryoablation is a newer treatment involving the AV node directly. SVT involving the AV node is often a contraindication to using radiofrequency ablation due to the small (1%) incidence of injuring the AV node, then requiring a permanent pacemaker. […] This therapy has further improved the treatment options for AVNRT (and other SVTs with pathways close to the AV node), widening the application of curative ablation to young patients with relatively mild but still troublesome symptoms who might not have accepted the risk of requiring a pacemaker.

• #1 Supraventricular Tachycardia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/supraventricular-tachycardia

  For conditions like Wolff-Parkinson-White syndrome, in which a hair-thin strand of tissue creates an extra electrical pathway between the upper and lower chambers of the heart, radiofrequency ablation offers a cure. It has become the treatment of choice for patients with that disorder who don’t respond well to drug therapy or who have a propensity for rapid heart rates. […] Internal cardioversion for conversion of atrial fibrillation and atrial flutter to a normal sinus rhythm also was developed here at UCSF Medical Center in 1991. […] An implantable cardioverter defibrillator is a device for people who are prone to life-threatening rapid heart rhythms. […] A new type of pacemaker, approved by the U.S. Food and Drug Administration, paces both ventricles of the heart to coordinate contractions and improve pumping ability. The minimally invasive technique has become the treatment of choice for arrhythmia patients who do not respond well to medication.

• #1 Supraventricular Tachycardia (SVT) in Children | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/supraventricular-tachycardia-svt

  Supraventricular tachycardia episodes usually stop on their own. Many babies with SVT will outgrow the arrhythmia by their first birthday. For children with SVT symptoms, treatment may include: […] Older children can learn to do vagal maneuvers to try to slow or stop an episode of fast heart rate. Vagal maneuvers may include: […] When tachycardia does not stop on its own or with vagal maneuvers, we may recommend a daily medication to prevent SVT from occurring. We may also treat SVT with an IV medicine, which immediately stops a fast heart rate. […] Depending on your child’s age and the severity and frequency of symptoms, the cardiologist may recommend a catheter ablation procedure to permanently eliminate SVT. During ablation, several IVs (small plastic tubes) are placed in the main blood vessels in the legs. Then, catheters (thin tubes) are advanced up through the veins and into the heart. Electrical signals from the catheters help locate the extra electrical connection, which can then be destroyed and eliminated by heating or freezing. The procedure takes several hours, and most children can go home on the same day. After successful treatment with ablation, your child should not experience any SVT episodes.

• #1 ESC Guidelines for Management of Supraventricular Tachycardia: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

  Multiple drugs have been removed from both the acute and chronic management of AV nodal re-entrant tachycardia (AVNRT). Verapamil, diltiazem, and beta-blockers remain as options for the chronic management of AVNRT, but they were downgraded from Class I to Class IIa. […] Catheter ablation is recommended in asymptomatic patients in whom electrophysiology testing with the use of isoprenaline identifies high-risk properties, such as shortest pre-excited RR interval during AF 250 ms, accessory pathway effective refractory period […] Sotalol, propranolol, quinidine, and procainamide are no longer used in the updated guidelines for SVT management in pregnant women. During the first trimester, it is recommended that all antiarrhythmic drugs are avoided. Beta-1 selective blockers (except atenolol) or verapamil should be considered for prevention of SVT in patients without Wolff-Parkinson-White (WPW) syndrome (Class IIa). Flecainide or propafenone should be considered for prevention of SVT in patients with WPW syndrome and without ischemic or structural heart disease (Class IIa).

• #1 ESC Guidelines for Management of Supraventricular Tachycardia: Key Points

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia

  SVTs have been reported as risk factors for sudden cardiac death in patients with adult congenital heart disease (ACHD). In ACHD, anticoagulation for focal AT or atrial flutter should be similar to that for patients with AF. Catheter ablation in experienced centers should be considered. Sotalol is not recommended as a first-line antiarrhythmic drug due to an increased risk of proarrhythmia and mortality (Class III). Flecainide and propafenone should be avoided in patients with left bundle branch block, or ischemic or structural heart disease (Class III). […] In postural orthostatic tachycardia syndrome, a regular and progressive exercise program should be considered (Class IIa). The consumption of up to 2-3 L of water and 10-12 g of sodium chloride daily, as well as midodrine, low-dose nonselective beta-blocker, pyridostigmine, and ivabradine may be considered (Class IIb).

• #1 SVT: Supraventricular Tachycardia – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/svt-supraventricular-tachycardia/

  Most often, sinus tachycardia resolves when its underlying cause, such as infection or dehydration, is treated. Inappropriate sinus tachycardia often does not require treatment because the prognosis is generally benign. There are no specific recommendations for the acute treatment of IST. However, once physiologic sinus tachycardia has been ruled out, ongoing IST can be treated with ivabradine or beta blockers, although the focus of treatment is on symptom reduction. For some patients with refractory symptoms, ivabradine and beta blockers in combination may be beneficial. […] In the acute setting, hemodynamically stable patients with suspected focal AT should receive IV beta blockers, diltiazem, or verapamil. In patients who are hemodynamically stable and whose diagnosis is unclear, IV adenosine can help differentiate focal AT from AVNRT and AVRT. If neither of these options works, treatment with IV amiodarone or IV ibutilide is recommended.

• #1 Supraventricular Tachycardia (SVT): Symptoms and Treatment

  https://www.verywellhealth.com/supraventricular-tachycardia-svt-1746255

  SVT, while rarely life-threatening, can cause significant symptoms and can become quite disruptive to a normal life. Fortunately, almost all varieties of SVT can be successfully treated and prevented. […] If you have SVT, your best bet is to talk to a cardiac electrophysiologist (a cardiologist who specializes in heart rhythm problems), who can review with you the pros and cons of all the treatment options available for your specific type of SVT.

• #1 Optimal SVT management: Are we there? – Professional Heart Daily | American Heart Association

  https://professional.heart.org/en/science-news/guideline-for-the-management-of-adult-patients-with-supraventricular-tachycardia/Commentary

  View the summary for 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients with Supraventricular Tachycardia […] The present document ably serves that purpose. Its figures and algorithms offer an easy-to-navigate, step-by-step decision-making guide to treating adult patients with all types of supraventricular tachycardias, other than atrial fibrillation. […] Figure 8 provides an algorithm for acute therapeutic decisions, while figure 9 gives advice on how to manage ongoing therapy, supported by information in tables 6 and 7. Table 8 outlines ablation for the individual arrhythmias, compiling success rates, complications, and references. This is critical, since so many SVTs can now be eliminated by catheter ablation techniques, a choice that can be considered early in the therapeutic setting. […] The remainder of the document addresses each SVT, providing a brief description, followed by a detailed citation of acute and ongoing therapeutic recommendations.

• #2 Supraventricular Tachycardia (SVT) Treatments | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/supraventricular-tachycardia/treatments.html

  Your treatment for SVT depends on a few things. They include what type of SVT, how often you have episodes, and how severe your symptoms are. The goals of treatment are to prevent episodes, relieve symptoms, and prevent problems. You and your doctor can decide what type of treatment is right for you. […] SVT is usually treated if: […] When episodes of SVT start suddenly and cause symptoms, you can try vagal maneuvers. Your doctor will teach you how to do these safely. […] If your heart rate cannot be slowed using vagal maneuvers, you may have to go to your doctor’s office or the emergency room, where a fast-acting medicine can be given to slow your heart rate. […] If you have recurring episodes of SVT, you may need to take medicines, either on an as-needed basis or daily. […] Many people with SVT have a procedure called catheter ablation. This procedure can stop the rhythm problem in most people. […] An electric shock to the heart is called electrical cardioversion. It may be needed if you are having severe symptoms of SVT and your heart rate doesn’t go back to normal using vagal maneuvers or fast-acting medicines.

• #2 Paroxysmal Supraventricular Tachycardia Treatment & Management: Approach Considerations, Vagal Maneuvers, Short-Term Pharmacologic Management

  https://emedicine.medscape.com/article/156670-treatment

  Guidelines on the management of supraventricular tachycardias (SVTs) are available from the American College of Cardiology/American Heart Association (2015), the European Heart Rhythm Association (2017), the European Society of Cardiology Scientific Group (2017), and the European Society of Cardiology (2019). […] Acute management of paroxysmal SVT includes controlling the rate and preventing hemodynamic collapse. If the patient is hypotensive or unstable, immediate cardioversion with sedation must be performed. If the patient is stable, vagal maneuvers can be used to slow the heart rate and to convert to sinus rhythm. If vagal maneuvers are not successful, adenosine can be used in increasing doses. If adenosine does not work, atrioventricular (AV) nodal blocking agents like calcium channel blockers or beta-blockers should be used, as most patients who present with PSVT have AV nodal reentrant tachycardia (AVNRT) or AV reentrant tachycardia (AVRT). These arrhythmias depend on AV nodal conduction and therefore can be terminated by transiently blocking this conduction.

• #2 Supraventricular Tachycardia (SVT): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22152-svt-supraventricular-tachycardia

  SVT (supraventricular tachycardia) is a common kind of arrhythmia (abnormal heart rhythm). […] There are some things you can do on your own, but you may need medicine or surgery to help with symptoms. […] If those dont help, you have lots of other options. […] Several medicines can slow down your heart rate: Adenosine, Atropine, Beta-blockers, Calcium channel blockers, Digitalis (digoxin), Potassium channel blockers. […] Your provider can use these methods for supraventricular tachycardia treatment: Vagal maneuvers like applying pressure to specific areas of your neck (carotid sinus massage), Cardioversion, which uses a shock to return your heart to a normal rhythm, Catheter ablation, which can eliminate the areas causing the abnormal electricity. […] If SVT is from causes you can change, you can: Manage your stress, Drink fewer alcohol-containing drinks, Stop using tobacco products, Drink less coffee and other things that have caffeine, Rest more. […] With successful treatments like catheter ablation, you can do many of the typical things you want to. Ablation can cure certain forms of SVT. […] Ask your healthcare provider which treatment is best for you.

• #2 Supraventricular Tachycardia – SVT

  https://aci.health.nsw.gov.au/networks/eci/clinical/tools/cardiology/supraventricular-tachycardia-svt

  The treatment for AVRT and AVNRT is the same for narrow complex tachycardias. Do not use these guidelines for wide complex tachycardias. […] Modified valsalva REVERT trial shows improved response to Valsalva manoeuvers if done sitting, sustained Valsalva for 15 secs(attempt to blow into 10ml syringe), then positioning flat and raising legs for 15 secs. This increased rates of cardioversion from 17% to 40%. […] Carotid sinus massage Patient supine with neck hyperextended, apply gentle pressure for 10-15secs. […] Mainstay of treatment is chemical cardioversion using intravenous Adenosine. This is recommended to be given at increments of 6mg, 12mg and then a further 12mg dose. […] Adenosine has a very short half life (10secs) and should be given via a large vein, ideally in the antecubital fossa. Give as a rapid bolus using a 3 way tap, then a 20mL rapid 0.9% saline flush.

• #2

• #2 Supraventricular Tachycardias: Causes, Symptoms, and Treatment

  https://patient.info/doctor/supraventricular-tachycardia-in-adults

  In haemodynamically stable regular narrow QRS-complex tachycardia, vagal manoeuvres – eg, Valsalva, carotid massage, facial immersion in cold water: […] Carotid massage is usually reserved for young patients. Due to the risk of stroke from emboli, auscultate for bruits before attempting this manoeuvre. Do not perform carotid massage on both sides simultaneously. […] Valsalva manoeuvre may induce cardioversion in 5-20% of patients. A modified Valsalva manoeuvre, in which the patient is laid flat and their legs elevated after the end of the strain phase, was shown in one randomised controlled trial (RCT) to increase the rate of cardioversion to over 40%. […] If vagal manoeuvres fail, give adenosine (if no pre-excitation) 6 mg rapid IV bolus; if unsuccessful, give 12 mg; if unsuccessful, give 18 mg. Monitor ECG continuously:

• #2 SVT: Supraventricular Tachycardia – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/svt-supraventricular-tachycardia/

  The management of SVT differs based on patient stability, patient preference, and the underlying SVT mechanism. The treatments described in the following sections are based on the 2015 American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) guidelines for treating SVT. […] Vagal maneuvers, including the Valsalva maneuver and carotid sinus massage, are the first-line interventions for SVT of unknown origin in stable patients. If vagal maneuvers do not terminate the SVT, intravenous (IV) adenosine is recommended. When first-line therapy is ineffective or contraindicated, and the patient is hemodynamically stable, IV beta blockers, IV verapamil, or IV diltiazem are recommended. If after receiving medical therapy patients are still in regular SVT, synchronized cardioversion is recommended. Hemodynamically unstable patients with regular SVT should undergo synchronized cardioversion.

• #2 Supraventricular Tachycardias: Causes, Symptoms, and Treatment

  https://patient.info/doctor/supraventricular-tachycardia-in-adults

  Ensure resuscitation equipment is available in case of ventricular fibrillation or bronchospasm. AV nodal blockers in a patient with WPW and atrial fibrillation can result in ventricular fibrillation. […] Intravenous adenosine is the treatment of choice except for people with severe asthma. Adenosine has a rapid onset and short half-life. It blocks conduction through the atrioventricular node. Adenosine has a high incidence of minor but unpleasant side-effects (eg, nausea, chest tightness, shortness of breath and headache). […] Intravenous verapamil has a more prolonged action than adenosine on blocking atrioventricular node conduction and there is a risk of prolonged depression of ventricular function and hypotension, especially if the person is taking a beta-blocker. It still has a place if adenosine is contra-indicated (eg, in somebody with severe asthma).

• #2 Supraventricular tachycardia (SVT) – EMCrit Project

  https://emcrit.org/ibcc/svt/

  Management of narrow-QRS tachycardia in the absence of an established diagnosis: Vagal maneuvers or adenosine, Cardioversion, Medical therapies. […] Vagal maneuvers or adenosine may be attempted for stable patients. […] IV adenosine: Traditional therapy for stable AVNRT. […] Calcium channel blockers are considered front-line therapy for managing stable patients with regular, narrow-QRS complex tachycardia. […] Beta-blockers are less effective at terminating SVT. […] Antiarrhythmic therapy may rarely be utilized in patients with difficulty tolerating CCB/Bbl therapy who aren’t immediate candidates for ablation. […] Catheter ablation may be utilized for recurrent or incessant FAT. […] Electrical cardioversion is generally effective for re-entrant arrhythmias, which constitute the majority of SVTs: AFib, AFlutter, AVNRT, AVRT. […] Cardioversion is unlikely to help for frequent arrhythmia recurrences. […] Adenosine may terminate a sustained run of FAT. […] DCCV can be effective for patients with micro-reentrant or triggered activity as a mechanism.

• #2 Supraventricular Tachycardia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441972/

  Implement evidence-based treatment protocols for acute and long-term management of supraventricular tachycardia, including vagal maneuvers, pharmacotherapy, and, when necessary, synchronized cardioversion. […] For unstable patients, immediate synchronized cardioversion should be considered. […] For patients with supraventricular tachycardia, the appropriate shock voltage for cardioversion is between 50 and 100 J. […] In stable patients, vagal maneuvers can be attempted while in the supine position as a preliminary approach before preparing for chemical cardioversion. […] If vagal maneuvers are not effective, pharmacotherapy becomes necessary. The first-line medication for supraventricular tachycardia is adenosine, an endogenous nucleoside that creates a transient blockade of the adenosine A1 receptors.

• #2 Supraventricular Tachycardia Treatment

  https://www.webmd.com/heart-disease/atrial-fibrillation/treatments-supraventricular-tachcardia

  You may be able to prevent your heart from racing by reducing or cutting out caffeine, alcohol, tobacco, diet pills, and any stimulant, even those found in decongestants. […] If one of these is the case, you may need to have the underlying condition treated first before you can start to get your SVT under control.

• #2 Diagnosis and Management of Common Types of Supraventricular Tachycardia | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1101/p793.html

  Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. […] Vagal maneuvers may terminate the arrhythmia; if this fails, adenosine is effective in the acute setting. […] Calcium channel blockers (diltiazem or verapamil) or beta blockers (metoprolol) can be used acutely or as long-term therapy. […] Class Ic antiarrhythmics (flecainide or propafenone) can be used long-term. […] Class III antiarrhythmics (amiodarone, sotalol, or dofetilide) are effective, but have potential adverse effects and should be administered in consultation with a cardiologist. […] Catheter ablation has a success rate of 95% and recurrence rate of less than 5%, and causes inadvertent heart block in less than 1% of patients. It is the preferred treatment for symptomatic patients with Wolff-Parkinson-White syndrome.

• #2 Paroxysmal Supraventricular Tachycardia Treatment & Management: Approach Considerations, Vagal Maneuvers, Short-Term Pharmacologic Management

  https://emedicine.medscape.com/article/156670-treatment

  Patients with symptomatic Wolff-Parkinson-White (WPW) syndrome should not be treated with calcium channel blockers or digoxin unless the pathway is known to be of low risk (long anterograde refractory period). This is because of the potential for rapid ventricular rates should atrial fibrillation or atrial flutter occur, which can result in cardiac arrest. […] Patients with preexcited atrial fibrillation should not be treated with intravenous AV nodal blocking agents, such as adenosine, beta-blockers, calcium channel blockers, and digoxin. Rather, if the patient is hemodynamically stable, intravenous procainamide should be administered. If the patient is unstable, direct current cardioversion should be performed. […] Electrical cardioversion is the most effective method for restoring sinus rhythm. Synchronized cardioversion starting at 50J can be used immediately in patients who are hypotensive, have pulmonary edema, have chest pain with ischemia, or are otherwise unstable.

• #2 Treatment

  http://www.cardiosmart.org/topics/supraventricular-tachycardia/treatment

  Cardioversion: In rare cases, you might require an electrical shock to get your heart back into a normal rhythm. […] Catheter ablation: Ablation can be considered as a primary, first-line therapy for certain types of SVT, and it may also be considered if you often have symptoms despite being on medical therapy. During an ablation, a catheter is placed through a vein typically in your leg, then guided to your heart. An electrical study is done to find the area in your heart causing the electrical problems that trigger SVT. Your doctor then destroys this area either by burning or freezing that part of the heart. […] Ablation is effective in treating specific forms of SVT. However, it does have some rare, but serious procedural risks. Be sure to talk about the procedure, and its risks and benefits, with your physician. Together with your health care team, you will find a treatment that is right for you.

• #2 Supraventricular tachycardia – Wikipedia

  https://en.wikipedia.org/wiki/Supraventricular_tachycardia

  Lifestyle changes, medication and heart procedures may be needed to control or eliminate the rapid heartbeats and related symptoms. […] Acute attacks of supraventricular tachycardia are treated with Esmolol (i.v.). […] Radiofrequency ablation has revolutionized the treatment of tachycardia caused by a re-entrant pathway. This is a low-risk procedure that uses a catheter inside the heart to deliver radiofrequency energy to locate and destroy the abnormal electrical pathways. […] Cryoablation is a newer treatment involving the AV node directly. SVT involving the AV node is often a contraindication to using radiofrequency ablation due to the small (1%) incidence of injuring the AV node, then requiring a permanent pacemaker. […] This therapy has further improved the treatment options for AVNRT (and other SVTs with pathways close to the AV node), widening the application of curative ablation to young patients with relatively mild but still troublesome symptoms who might not have accepted the risk of requiring a pacemaker.

• #2 Supraventricular tachycardia | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/supraventricular-tachycardia/

  For people with symptoms that are affecting their day to day life, or who have significant episodes, medication can be offered. These may be a beta blocker or other medications to help stabilise the pathway and reduce the hearts ability to cause the fast heart rates. […] The most effective long term treatment for SVT is cardiac ablation. The doctor will use either radio frequency ablation (heating therapy) or cryoablation (freezing therapy) on the affected area, which should stop the abnormal signals. Ablation works by using a targeted beam of energy to destroy the tissues causing the abnormal signals. Radio frequency ablation (heating therapy) is effective in around 90 per cent or more of cases. Cryoablation (freezing therpay), is used where RF ablation is not suitable. Cryoablation freezes the affected area and is effective in about 80 per cent of the cases; however, it is safer to use in certain areas of your heart. This procedure is carried out at low risk and as a day case or with an overnight stay. Ablation is successful in the vast majority of cases, so there are no further heart racing episodes.

• #2 Supraventricular Tachycardia (SVT): Types, Causes, & Risk Factors

  https://www.webmd.com/heart-disease/atrial-fibrillation/what-is-supraventricular-tachycardia

  In an emergency, a doctor can place a set of paddles or patches on your chest to deliver an electric shock to your heart. This helps your heartbeat return to normal. […] For this treatment, doctors thread tiny tubes (called catheters) through a vein to your heart. These release a pulse of heat or cold that destroys the abnormal electrical pathway that causes SVT. […] In rare cases, a surgeon can put a tiny device called a pacemaker in your chest. When your heart isn’t beating normally, this device delivers a small shock to help it return to its regular rhythm.

• #2 Supraventricular Tachycardia (SVT) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/supraventricular-tachycardia.html

  Many arrhythmias like SVT may not need treatment. […] Treatment might be done when SVT causes symptoms, lasts a long time, or happens often. Options include: […] Medicine. Doctors may use medicines (such as beta blockers) that slow the heart rate. This lowers the chances of having frequent or long episodes of SVT. Sometimes, these cause side effects, so a child will see the doctor regularly. […] Catheter ablation. With the child asleep and comfortable, doctors guide a catheter (a thin, flexible plastic wire) through a vein or artery in the leg to the heart. When the problem area of the heart is pinpointed, the catheter tip can use hot energy (called radiofrequency ablation) or cold energy (called cryoablation) to burn or freeze the tissues causing the arrhythmia.

• #2 Supraventricular Tachycardia: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/heart/arrhythmias/supraventricular-tachycardia-svt/treatment

  Most patients with supraventricular tachycardia don’t need treatment. For those with symptoms, nonsurgical and surgical options are available. […] Your doctor will recommend the most appropriate treatment for your specific situation. Surgical procedures to treat SVT are used when nonsurgical treatments of lifestyle changes, vagal maneuvers, and medications do not work.

• #2 Current Trends in Supraventricular Tachycardia Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4295736/

  Given the high success rates and favorable safety profiles of diagnostic electrophysiology study followed by an attempt at catheter ablation, many patients choose this option early in their course. However, pharmacologic therapy is an important treatment option and can be well tolerated and effective in some patients. […] The first catheter ablations for SVT occurred in the early to mid-1980s and employed sequential intracardiac delivery of 2-10 direct current shocks to disrupt and ablate myocardial tissue, with shock energy deliveries as high as 300-400 J per delivery. […] Success rates for accessory pathway ablation range from 95%-98%, with recurrence rates of AVRT as low as 2%, although location of the accessory pathway can have a significant effect on success rates (posteroseptal and right-sided pathways are more challenging).

• #2 Supraventricular Tachycardia (SVT) – Melbourne Heart Group

  https://www.melbourneheart.com.au/for-patients/supraventricular-tachycardia-svt/

  In certain cases, particularly with atrial tachycardia, the use of a pacemaker may be necessary to safely and effectively administer medications. […] The concept of the pill-in-the-pocket approach involves the utilisation of specific prescribed medications, typically beta blockers, calcium channel blockers, flecainide, or sotalol. […] A Catheter ablation is a common and minimally invasive procedure where the abnormal circuit is identified and ablated to prevent recurrence. Effectiveness can vary between different types of SVT but is generally 90-95% with 1 or 2 procedures. AVNRT is expected to respond very well to ablation with 98% efficacy.

• #2 Current Trends in Supraventricular Tachycardia Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4295736/

  Supraventricular tachycardia (SVT) is a general term describing a group of arrhythmias whose mechanism involves or is above the atrioventricular node. The mechanisms of most forms of SVT have been elucidated, and pharmacologic and invasive therapies have evolved simultaneously. […] In the acute setting, vagal maneuvers and pharmacologic therapy can be effective in arrhythmia termination. Catheter-based radiofrequency ablation has revolutionized therapy for many SVTs, and newer techniques have significantly improved ablation efficacy and reduced periprocedural complications and procedure times. Cryoablation is currently being investigated as an alternative form of energy delivery, although the long-term effectiveness of this procedure currently limits its use for many SVTs. […] Pharmacologic therapy for acute termination of SVT is appropriate in patients when vagal maneuvers fail. The preferred initial agents are intravenous (IV) adenosine or a nondihydropyridine calcium channel blocker.

• #3 Paroxysmal Supraventricular Tachycardia Medication: Cardiovascular, Other, Calcium Channel Blockers, Beta-Blockers, Beta-1 Selective, Beta-blockers, Nonselective

  https://emedicine.medscape.com/article/156670-medication

  Treatment for atrial fibrillation and atrial flutter includes medications that control the ventricular rate (calcium channel blockers, digoxin, amiodarone, beta-blockers), restore the sinus rhythm (such as ibutilide, flecainide, amiodarone, propafenone), and prevent embolic complications. […] Long-term pharmacologic therapy for patients with SVT depends on the type of tachyarrhythmia that is occurring and the frequency and duration of episodes, as well as the symptoms and the risks associated with the arrhythmia (eg, heart failure, sudden death). […] Adenosine is the first-line medical treatment for the termination of paroxysmal SVT. It is a short-acting agent that alters potassium conductance into cells and results in hyperpolarization of nodal cells. This increases the threshold to trigger an action potential and results in sinus slowing and the blockage of AV conduction.

• #3 Paroxysmal Supraventricular Tachycardia Treatment & Management: Approach Considerations, Vagal Maneuvers, Short-Term Pharmacologic Management

  https://emedicine.medscape.com/article/156670-treatment

  Patients with symptomatic Wolff-Parkinson-White (WPW) syndrome should not be treated with calcium channel blockers or digoxin unless the pathway is known to be of low risk (long anterograde refractory period). This is because of the potential for rapid ventricular rates should atrial fibrillation or atrial flutter occur, which can result in cardiac arrest. […] Patients with preexcited atrial fibrillation should not be treated with intravenous AV nodal blocking agents, such as adenosine, beta-blockers, calcium channel blockers, and digoxin. Rather, if the patient is hemodynamically stable, intravenous procainamide should be administered. If the patient is unstable, direct current cardioversion should be performed. […] Electrical cardioversion is the most effective method for restoring sinus rhythm. Synchronized cardioversion starting at 50J can be used immediately in patients who are hypotensive, have pulmonary edema, have chest pain with ischemia, or are otherwise unstable.

• #3 Supraventricular Tachycardia Self-Care: Tips & Treatment Options

  https://www.reviveresearch.org/blog/supraventricular-tachycardia-self-care/

  Supraventricular tachycardia (SVT) is characterized by an abnormally fast heartbeat above the hearts ventricles. While medical treatment is essential, understanding and implementing supraventricular tachycardia self-care can significantly improve quality of life and help manage symptoms. […] Self-care is a crucial component of managing supraventricular tachycardia. By adopting lifestyle changes and practices, one can reduce episode frequency and severity. Here are some supraventricular tachycardia self-care tips to help control heart health. […] One of the most important aspects of supraventricular tachycardia self-care is to regularly monitor heart rate. Keeping track of heart rate can help identify triggers and patterns. […] Dehydration can trigger SVT episodes, so staying hydrated is essential.

• #3 Medications to Treat SVT | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/supraventricular-tachycardia/treatments/medications.html

  To best treat supraventricular tachycardia, medications need to affect the conductivity of the A-V node, the staircase between the upper and lower heart chambers. […] These medications include: Beta-blocking agents, Calcium channel agents, Digoxin. […] Usually, these medications are taken daily, and take approximately 10-20 minutes to act. […] For patients who have longer episodes of supraventricular tachycardia, a quick-acting version of one of these three medications may be given. […] For those who experience brief episodes of supraventricular tachycardia that last less than one or two minutes, daily medication may not be needed.

• #3 Current Trends in Supraventricular Tachycardia Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4295736/

  Given the high success rates and favorable safety profiles of diagnostic electrophysiology study followed by an attempt at catheter ablation, many patients choose this option early in their course. However, pharmacologic therapy is an important treatment option and can be well tolerated and effective in some patients. […] The first catheter ablations for SVT occurred in the early to mid-1980s and employed sequential intracardiac delivery of 2-10 direct current shocks to disrupt and ablate myocardial tissue, with shock energy deliveries as high as 300-400 J per delivery. […] Success rates for accessory pathway ablation range from 95%-98%, with recurrence rates of AVRT as low as 2%, although location of the accessory pathway can have a significant effect on success rates (posteroseptal and right-sided pathways are more challenging).

• #3 Supraventricular Tachycardia: Which Patient Should be Treated with Radiofrequency Ablation? | USC Journal

  https://www.uscjournal.com/articles/supraventricular-tachycardia-which-patient-should-be-treated-radiofrequency-ablation?language_content_entity=en

  Indeed, many patients, informed of the risks and benefits of catheter ablation, prefer this approach than a long-term antiarrhythmic drug therapy. […] Medical treatment of SVT with antiarrhythmic drugs has limited efficacy and may cause adverse effects or be inconvenient to young patients. The safety and efficacy of radiofrequency catheter ablation for treatment of most types of SVT is well established. Ablation for most SVT has such a low complication rate and high success rate that it is more cost-effective and may be safer than antiarrhythmic drugs.

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