What are the AHA/ACC/HRS guidelines for the acute management of supraventricular tachycardia (SVT) in Wolff-Parkinson-White (WPW) syndrome?

Updated: Jan 08, 2017
  • Author: Christopher R Ellis, MD, FACC, FHRS; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

Vagal maneuvers and/or IV adenosine are the recommended initial treatments for acute AVRT. (Class I; Level of evidence B-R)

Additional recommendations for acute treatment when adenosine and vagal maneuvers are ineffective or contraindicated are summarized below.

Hemodynamically unstable patients

  • Synchronized cardioversion (class I; level of evidence, B-NR)

Hemodynamically stable patients

  • IV beta blockers, diltiazem, or verapamil (class IIa; level of evidence, B-R for patients without preexcitation on their resting ECG during sinus rhythm; and class IIb; level of evidence, B-R for patients with preexcitation on their resting ECG during sinus rhythm)
  • Synchronized cardioversion when beta blockers, diltiazem, or verapamil are ineffective or contraindicated (class I; level of evidence, B-NR)

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