Drug of choice in supraventricular tachycardia
Drug of choice in supraventricular tachycardia Supraventricular tachycardia (SVT) is a common arrhythmia characterized by a rapid heart rate originating above the ventricles. It can cause symptoms such as palpitations, dizziness, shortness of breath, and even fainting, impacting quality of life and, in some cases, leading to more serious complications. Effective management of SVT hinges on prompt and appropriate intervention, with the choice of medication playing a pivotal role.
The initial approach to treating SVT varies depending on the severity of symptoms, the patient’s stability, and underlying health conditions. In emergency situations where the patient is hemodynamically unstable—showing signs such as hypotension, chest pain, or altered mental status—immediate synchronized electrical cardioversion is often the preferred and definitive treatment. However, for stable patients, pharmacological therapy remains the cornerstone of acute management.
Vagal maneuvers are first-line interventions for stable SVT and can often terminate episodes. Techniques such as the Valsalva maneuver or carotid sinus massage stimulate the vagus nerve, which can temporarily slow conduction through the atrioventricular (AV) node and restore normal rhythm. When vagal maneuvers fail or are contraindicated, pharmacotherapy is typically employed. Drug of choice in supraventricular tachycardia
The drug of choice in acute SVT management is intravenous adenosine. Adenosine works rapidly by activating adenosine receptors in the AV node, leading to transient AV nodal blockade. This interruption of the reentrant circuit frequently results in the cessation of the tachycardia within seconds. Its ultra-rapid onset and short half-life make it ideal for emergency settings. Despite its effectiveness, adenosine can cause transient side effects such as chest discomfort, flushing, or brief asystole, but these are generally well-tolerated given its short duration.
If adenosine is contraindicated, ineffective, or not tolerated, other options include calcium channel blockers like verapamil or diltiazem. These agents inhibit calcium influx into the AV node, reducing conduction velocity and helping to terminate the arrhythmia. They are useful in cases where adenosine cannot be administered or as long-term management options. Drug of choice in supraventricular tachycardia
Beta-blockers, such as metoprolol, can also be used in acute settings, especially in patients with underlying cardiac conditions. They decrease sympathetic stimulation, slow AV nodal conduction, and are effective in controlling recurrent episodes. Drug of choice in supraventricular tachycardia
Drug of choice in supraventricular tachycardia For long-term control, especially in patients with recurrent SVT, medications like calcium channel blockers or antiarrhythmic drugs are considered. Catheter ablation, a minimally invasive procedure targeting the arrhythmogenic focus, offers a potential cure and is increasingly favored for suitable candidates.
In summary, while multiple medications can be employed to manage SVT, adenosine remains the drug of choice for acute, stable episodes owing to its efficacy, rapid action, and safety profile. Understanding these options ensures prompt, effective treatment and improved patient outcomes. Drug of choice in supraventricular tachycardia
