Supraventricular tachycardia AHA recommendations for Management of SVT of Unknown Mechanism: Difference between revisions
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Sotalol may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-R]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Sotalol may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-R]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''Dofetilide may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, or | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Dofetilide may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, or | ||
verapamil are ineffective or contraindicated ( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R])'' <nowiki>"</nowiki> | verapamil are ineffective or contraindicated ( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.'''Oral amiodarone may be considered for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, dofetilide, | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Oral amiodarone may be considered for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, dofetilide, | ||
flecainide, propafenone, sotalol, or verapamil are ineffective or contraindicated( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | flecainide, propafenone, sotalol, or verapamil are ineffective or contraindicated( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.'''Oral digoxin may be reasonable for ongoing management in patients with symptomatic SVT without pre-excitation who are not candidates for, or prefer not to undergo, catheter ablation( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.''' Oral digoxin may be reasonable for ongoing management in patients with symptomatic SVT without pre-excitation who are not candidates for, or prefer not to undergo, catheter ablation( </nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
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Revision as of 14:30, 27 October 2016
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Resident Survival Guide |
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Supraventricular tachycardia Microchapters |
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Differentiating Among the Different Types of Supraventricular Tachycardia |
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Differentiating Supraventricular Tachycardia from Ventricular Tachycardia |
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Diagnosis |
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Treatment |
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2015 ACC/AHA Guideline Recommendations |
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Case Studies |
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Supraventricular tachycardia AHA recommendations for Management of SVT of Unknown Mechanism On the Web |
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Directions to Hospitals Treating Supraventricular tachycardia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Aysha Anwar, M.B.B.S[2]
Overview
2015 AHA recommendations for Management of SVT of unknown mechanism include vagal maneuvers, adenosine, intravenous diltiazem or verapamil, intravenous beta blockers, oral beta blockers, diltiazem, or verapamil, flecainide or propafenone and synchronized cardioversion.
Management of SVT of Unknown Mechanism
Recommendations for Acute Treatment of SVT of Unknown Mechanism
| Class I |
| "1. Vagal maneuvers are recommended for acute treatment in patients with regular SVT "(Level of Evidence: B-R) " |
| "2. Adenosine is recommended for acute treatment in patients with regular SVT </nowiki>"</nowiki>(Level of Evidence: B-R) " |
| "3. Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically unstable SVT when vagal maneuvers or adenosine are ineffective or not feasible " (Level of Evidence: B-NR) " |
| "4. Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically stable SVT when pharmacological therapy is ineffective or contraindicated "(Level of Evidence: B-NR) " |
| Class IIa |
| "1. Intravenous diltiazem or verapamil can be effective for acute treatment in patients with hemodynamically stable SVT "(Level of Evidence:B-R) " |
| "2. Intravenous beta blockers are reasonable for acute treatment in patients with hemodynamically stable SVT "(Level of Evidence: C-LD) " |
Recommendations for Ongoing Management of SVT of Unknown Mechanism
| Class I |
| "1.Oral beta blockers, diltiazem, or verapamil is useful for ongoing management in patients with symptomatic SVT who do not have ventricular pre-excitation during sinus rhythm"(Level of Evidence: B-R) " |
| "2.Electrophysiological (EP) study with the option of ablation is useful for the diagnosis and potential treatment of SVT ( </nowiki>"</nowiki>(Level of Evidence: B-NR) " |
| "3.Patients with SVT should be educated on how to perform vagal maneuvers for ongoing management of SVT " (Level of Evidence: C-LD) " |
| Class IIa |
| "1.Flecainide or propafenone is reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have symptomatic SVT and are not candidates for, or prefer not to undergo, catheter ablation "(Level of Evidence:B-R) " |
| Class IIb |
| "1. Sotalol may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation "(Level of Evidence:B-R) " |
| "2. Dofetilide may be reasonable for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, or
verapamil are ineffective or contraindicated ( </nowiki>"</nowiki>([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]) " |
| "3. Oral amiodarone may be considered for ongoing management in patients with symptomatic SVT who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, dofetilide,
flecainide, propafenone, sotalol, or verapamil are ineffective or contraindicated( </nowiki>"</nowiki>(Level of Evidence: C-LD) " |
| "4. Oral digoxin may be reasonable for ongoing management in patients with symptomatic SVT without pre-excitation who are not candidates for, or prefer not to undergo, catheter ablation( </nowiki>"</nowiki>(Level of Evidence: C-LD) " |