![cardizem drip cardizem drip](https://i.pinimg.com/originals/7e/ba/fb/7ebafbb95087355af6568c3add9efc05.png)
IV beta-blockers, diltiazem, or verapamil (class IIa recommendations)īefore the introduction of adenosine in 1989, verapamil was the mainstay of treatment of stable PSVT.Vagal maneuvers and/or IV adenosine (class I recommendations).When vagal maneuvers or adenosine are ineffective or not feasible, perform synchronized cardioversion (class I recommendation).Consider adenosine if the tachycardia is regular and narrow complex.2,3 GuidelinesĪdvanced Cardiac Life Support (ACLS) guidelines and joint guidelines released in 2015 by the American Heart Association, American College of Cardiology, and the Heart Rhythm Society (AHA/ACC/HRS) recommend both pharmacologic and non-pharmacologic therapies for the acute management of PSVT. While AVNRT and AVRT will likely terminate with AV nodal blocking agents, AT is not dependent on the AV node and these agents will typically only slow ventricular response rate. 2 Treatment pathways for PSVT depend on hemodynamic stability and underlying rhythm. 1 The 3 most common types of PSVT are atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reciprocating tachycardia (AVRT), and atrial tachycardia (AT). It represents a subset of SVT, an umbrella term used to describe tachycardias involving tissue from the His bundle or above. PSVT is a clinical syndrome characterized by the presence of a regular and rapid tachycardia of abrupt onset and termination. After all, it’s been over 20 years since we switched to using adenosine first-line. You recently read about using calcium channel blockers (CCBs) for paroxysmal SVT (PSVT), but can’t recall the last time you actually considered using them.