Which intervention is commonly effective for stable narrow-complex supraventricular tachycardia?

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Multiple Choice

Which intervention is commonly effective for stable narrow-complex supraventricular tachycardia?

For stable narrow-complex supraventricular tachycardia, the most effective and appropriate first-step intervention is vagal maneuvers. These maneuvers increase parasympathetic tone to the AV node, slowing conduction through the AV node and often interrupting the reentrant circuit that sustains the tachycardia. In many AV nodal–dependent SVTs, such as AVNRT or AVRT with AV nodal involvement, this can terminate the tachycardia and restore normal rhythm without medications or electricity. Common examples are the Valsalva maneuver or carotid sinus massage, performed only in appropriate patients (avoiding carotid massage in those with carotid disease or after recent neck trauma, etc.). Defibrillation is for pulseless ventricular arrhythmias like VF. Synchronized cardioversion is reserved for unstable patients or when vagal maneuvers and medications fail. Thrombolysis has no role in treating SVT; it’s used for thrombotic occlusions or certain acute coronary conditions.

For stable narrow-complex supraventricular tachycardia, the most effective and appropriate first-step intervention is vagal maneuvers. These maneuvers increase parasympathetic tone to the AV node, slowing conduction through the AV node and often interrupting the reentrant circuit that sustains the tachycardia. In many AV nodal–dependent SVTs, such as AVNRT or AVRT with AV nodal involvement, this can terminate the tachycardia and restore normal rhythm without medications or electricity. Common examples are the Valsalva maneuver or carotid sinus massage, performed only in appropriate patients (avoiding carotid massage in those with carotid disease or after recent neck trauma, etc.).

Defibrillation is for pulseless ventricular arrhythmias like VF. Synchronized cardioversion is reserved for unstable patients or when vagal maneuvers and medications fail. Thrombolysis has no role in treating SVT; it’s used for thrombotic occlusions or certain acute coronary conditions.

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