Cardiovascular Medicine Book

Approach

Atrial Fibrillation

Bradycardia

Information Resources

Miscellaneous

Symptoms

Tachycardia

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Examination Chapter related topics

Myocardial Disorders Chapter related topics

Obstetrics Chapter related topics

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Supraventricular Tachycardia Management in the Adult

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  1. See Also
    1. Guidelines 2000 CPR and Emergency Cardiovascular Care
    2. Unstable Tachycardia
  2. Management: 2000 Guideline - Junctional Tachycardia
    1. Preserved Cardiac Function
      1. No Synchronized Cardioversion
      2. Amiodarone 150 mg IV bolus over 10 minutes
      3. Beta Blocker
      4. Calcium Channel Blocker: Verapamil
        1. First: 2.5-5.0 mg IV, then wait 15-30 min
        2. Second: 5-10 mg IV
    2. Decreased Cardiac Function (Ejection Fraction <40%)
      1. No Synchronized Cardioversion
      2. Amiodarone 150 mg IV bolus over 10 minutes
  3. Management: 2000 guidelines - PSVT
    1. Preserved Cardiac Function
      1. First Line Interventions (in priority order)
        1. Calcium Channel Blocker: Verapamil
          1. First: 2.5-5.0 mg IV, then wait 15-30 min
          2. Second: 5-10 mg IV
        2. Beta Blocker
        3. Digoxin
        4. Synchronized Cardioversion
      2. Second line interventions
        1. Procainamide
        2. Amiodarone
        3. Sotalol
    2. Decreased Cardiac Function (Ejection Fraction <40%)
      1. No Synchronized Cardioversion
      2. Digoxin
      3. Amiodarone 150 mg IV bolus over 10 minutes
      4. Diltiazem
  4. Management: 2000 - Ectopic, Multifocal Atrial Tachycardia
    1. Preserved Cardiac Function
      1. No Synchronized Cardioversion
      2. Calcium Channel Blocker: Verapamil
        1. First: 2.5-5.0 mg IV, then wait 15-30 min
        2. Second: 5-10 mg IV
      3. Beta Blocker
      4. Amiodarone 150 mg IV bolus over 10 minutes
    2. Decreased Cardiac Function (Ejection Fraction <40%)
      1. No Synchronized Cardioversion
      2. Amiodarone 150 mg IV bolus over 10 minutes
      3. Diltiazem
  5. Management: Long-term management
    1. Medication control
    2. Radiofrequency ablation
      1. Accessory Pathway (e.g. WPW)
      2. Atrioventricular nodal reentrant tachycardia
      3. Atrial tachycardia
  6. References
    1. (2000) Circulation, 102(Suppl I):86-9
    2. http://www.circulationaha.org

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