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Supraventricular Tachycardia Management in the Adult - Old Guidelines
- See Also
- Supraventricular Tachycardia Management in the Adult (current guidelines)
- Background
- Old Guidelines shown for historical reasons and to look at SVT from a different approach
- Follow new guidelines in choosing medications to treat SVT
- Management: Step 1 - Stable SVT
- See Unstable Tachycardia if unstable
- Regular SVT
- See Step 2 below
- Irregular SVT: Atrial Fibrillation (or flutter, MAT)
- Consider expert consultation
- Control Heart Rate
- Diltiazem
- Beta Blockers (avoid in COPD or uncompensated CHF)
- Management: Step 2 - Regular SVT
- See Unstable Tachycardia if unstable
- Vagal stimulation
- Carotid Massage (avoid if risk of embolism)
- Valsalva maneuver
- Adenosine
- First: 6 mg rapid IV push over 1-3 seconds
- Second: 12 mg rapid IV push over 1-3 seconds
- Assess QRS Complex morphology and timing
- Junctional tachycardia
- Paroxysmal Supraventricular Tachycardia
- Ectopic or Multifocal Atrial Tachycardia
- Confirm not wide-complex tachycardia
- Calcium Channel Blockers contraindicated
- Management: Step 3 - Regular SVT
- Rhythm converts with vagal maneuvers or Adenosine
- Consistent with re-entry SVT
- Protocol for recurrence of SVT
- Repeat Adenosine dose or
- Diltiazem or
- Beta Blockers
- Rhythm does not convert with vagal maneuvers, Adenosine
- Consider Atrial flutter, ectopic or junctional rhythm
- Consider expert consultation
- Control Heart Rate
- Diltiazem
- Beta Blockers (avoid in COPD or uncompensated CHF)
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