Drug of choice supraventricular tachycardia
Drug of choice supraventricular tachycardia Supraventricular tachycardia (SVT) is a common form of rapid heart rhythm originating above the ventricles, typically in the atria or the atrioventricular (AV) node. It often presents with sudden episodes of rapid heartbeat, palpitations, dizziness, or shortness of breath. Managing SVT effectively requires prompt recognition and appropriate treatment, with pharmacological intervention playing a crucial role.
The drug of choice for acute episodes of SVT is often adenosine. Adenosine acts rapidly by temporarily blocking conduction through the AV node, which is often the critical pathway involved in re-entrant circuits that cause SVT. Its quick onset and brief duration make it ideal for terminating episodes of SVT. When administered intravenously, typically as a rapid bolus followed by a saline flush, adenosine can restore normal sinus rhythm within seconds. However, as it can cause transient side effects such as chest discomfort, flushing, or brief asystole, it should be administered under medical supervision with appropriate resuscitation equipment available.
In cases where adenosine is contraindicated, ineffective, or not tolerated, other medications are utilized. Calcium channel blockers, particularly verapamil and diltiazem, are considered second-line agents. These drugs work by inhibiting calcium influx in the cardiac conduction system, especially in the AV node, thereby slowing conduction and often terminating SVT episodes. Verapamil is effective but carries the risk of hypotension and AV block, so careful monitoring is necessary during administration. Drug of choice supraventricular tachycardia
Beta-blockers, such as metoprolol or propranolol, are also effective in controlling SVT, especially in patients with recurrent episodes or those with underlying structural heart disease. They reduce sympathetic stimulation, thereby decreasing heart rate and stabilizing conduction pathways. These are often used as chronic management options rather than acute abortive agents, although they can be administered intravenously in emergency settings.
Other antiarrhythmic drugs like digoxin or amiodarone may be considered in specific cases, particularly in patients with concomitant heart failure or other arrhythmias. However, their use is generally reserved for cases resistant to first-line agents or in chronic management. Drug of choice supraventricular tachycardia
Beyond pharmacotherapy, vagal maneuvers are simple, non-invasive techniques that can sometimes terminate SVT episodes. Techniques such as the Valsalva maneuver or carotid sinus massage increase vagal tone, slowing conduction through the AV node and potentially stopping the arrhythmia before medication is needed. Drug of choice supraventricular tachycardia
Drug of choice supraventricular tachycardia In summary, adenosine remains the first-line drug of choice for the acute termination of SVT due to its rapid action and high efficacy. When unavailable or contraindicated, calcium channel blockers and beta-blockers are valuable alternatives. Proper management involves not only pharmacological intervention but also patient education about recognizing symptoms and seeking prompt medical attention.
Effective treatment of SVT can significantly improve quality of life and prevent complications. Long-term management may include medications or procedures like catheter ablation, especially in recurrent cases. Overall, understanding the pharmacological options allows clinicians to tailor therapy to individual patient needs, ensuring safe and effective control of this common arrhythmia. Drug of choice supraventricular tachycardia
