Treatment of Stable Narrow-Complex Tachycardia
Regular Rhythm:
• Attempt vagal maneuvers
• Give adenosine 6 milligrams IV push followed by 12 milligrams IV push if does not convert
- Repeat 12-milligram dose once
• Converts - Probably AVnRT or AVRT
- Observe and monitor
- Repeat adenosine if returns
- Control rate with AV nodal blocking agents (diltiazem or B-blockers)
• Does not convert - Possible atrial flutter, ectopic atrial tachycardia, junctional tachycardia
- Control rate (e.g., diltiazem or B-blockers, use B-blockers with caution in pulmonary disease or CHF)
- Treat underlying cause
Irregular Rhythm:
• Probable atrial fibrillation or possible atrial flutter or MAT
- Control rate (e.g., diltiazem or B-blockers, use B-blockers with caution in pulmonary disease or CHF)
- Treat underlying cause
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