AVNRT medical therapy: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Medical therapy can be initiated with drugs that slow AV nodal conduction | Medical therapy can be initiated with drugs that slow AV nodal conduction: | ||
==First Line Therapy= | ==== First Line Therapy ==== | ||
===[[ | ===== [[Adenosine]] ===== | ||
Adenosine is generally considered first line therapy for AVNRT. | |||
Treatment of AVNRT with adenosine can be complicated by: | |||
*The development of [[shortness of breath]] due to [[bronchospasm]] | |||
*In some cases there can be [[asystole]] which is transient given the short [[half life]] of adenosine | |||
*[[Atrial fibrillation]] may be induced by [[adenosine]] administration | |||
*[[Ventricular fibrillation]] is rarely induced by adenosine. When it does occur it is due to block of the [[AV node]] with rapid antegrade conduction of [[atrial fibrillation]] down the bypass tract. It is for this reason that [[defibrillation]] equipment be available. | |||
*Adenosine should not be used in [[heart transplant]] patients | |||
*[[Dipyridamole]] may potentiate the effect of [[adenosine]] | |||
*[[Theophylline]] may reduce the effectiveness of [[adenosine]] | |||
Administration: | |||
*Place a large bore (18 gauge and larger) intravenous line | |||
*The initial dose is 6 mg and this should be followed a saline flush with elevation of the arm to assure that the drug is infused | |||
*If this is not effective, then 12 mg or 18 mg of [[adenosine]] can be admininistered | |||
=====[[Beta blocker]]s===== | |||
A short acting beta-blocker such as [[esmolol]] (half life of 8 minutes) can be used to terminate an episode of AVNRT. Longer acting beta-blockers such as [[atenolol]], [[metoprolol]], and [[propranolol]] can also be used to reduce the risk of recurrent episodes. [[Atenolol]] may be preferable among patients with [[bronchospasm]] as it selectively blocks [[beta-1 receptors]] with little effect on [[beta- 2 receptors]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 21:08, 9 September 2012
|
AVNRT Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
AVNRT medical therapy On the Web |
|
American Roentgen Ray Society Images of AVNRT medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical therapy can be initiated with drugs that slow AV nodal conduction:
First Line Therapy
Adenosine
Adenosine is generally considered first line therapy for AVNRT.
Treatment of AVNRT with adenosine can be complicated by:
- The development of shortness of breath due to bronchospasm
- In some cases there can be asystole which is transient given the short half life of adenosine
- Atrial fibrillation may be induced by adenosine administration
- Ventricular fibrillation is rarely induced by adenosine. When it does occur it is due to block of the AV node with rapid antegrade conduction of atrial fibrillation down the bypass tract. It is for this reason that defibrillation equipment be available.
- Adenosine should not be used in heart transplant patients
- Dipyridamole may potentiate the effect of adenosine
- Theophylline may reduce the effectiveness of adenosine
Administration:
- Place a large bore (18 gauge and larger) intravenous line
- The initial dose is 6 mg and this should be followed a saline flush with elevation of the arm to assure that the drug is infused
- If this is not effective, then 12 mg or 18 mg of adenosine can be admininistered
Beta blockers
A short acting beta-blocker such as esmolol (half life of 8 minutes) can be used to terminate an episode of AVNRT. Longer acting beta-blockers such as atenolol, metoprolol, and propranolol can also be used to reduce the risk of recurrent episodes. Atenolol may be preferable among patients with bronchospasm as it selectively blocks beta-1 receptors with little effect on beta- 2 receptors.