Supraventricular tachycardia (SVT)
A faster than normal heart rate beginning above the heart’s two lower chambers.Supraventricular tachycardia is a rapid heartbeat that develops when the normal electrical impulses of the heart are disrupted.
If stable then :- ECG -> vagal maneuvers-> adenosine 6mg iv/io no change then 12 mg each with 10cc flush -> amiodarone 150/100ml Dsw over 10 min or cardizem 0.25 mg/kg
If unstable then:-adenosine 12 mg iv/io with 10cc flush -> sedate for cardioversion with Etimidate 3mg/kg not more than30mg or versed 2-4 mg iv/io -> synchronised cardioversion 50 J if unsuccessful then 100J if again unsuccessful -> amiodarone 150/100ml Dsw over 10 min or cardizem 0.25 mg/kg-> ECG
- Carotid sinus massage. A doctor applies gentle pressure on the neck where the carotid artery splits into two branches. During this type of massage, the body releases chemicals that slow the heart rate. Don’t attempt to do this on your own.
- Vagal maneuvers. You may be able to stop an episode of SVT by using particular movements such as holding your breath and straining as you would during a bowel movement, dunking your face in ice water, or coughing. These maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow.
- Cardioversion. If you’re unable to stop an episode of SVT on your own using vagal maneuvers, your doctor may use cardioversion. Cardioversion may be done using medications or during a heart procedure.In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical signals in your heart and can restore a normal rhythm.
- Medications. If you have frequent episodes of SVT, your doctor may prescribe medication to control your heart rate or restore a normal heart rhythm. It’s very important to take the medication exactly as directed by your doctor in order to reduce complications.
- Catheter ablation. In this procedure, the doctor inserts thin, flexible tubes called catheters through the veins or arteries, usually in the groin. Sensors on the tip of the catheter use heat or cold energy to create tiny scars in your heart to block abnormal electrical signals and restore a normal heartbeat.
- Pacemaker. Rarely, a small, implantable device called a pacemaker is used to stimulate your heart to beat at a normal rate. The pacemaker is placed under the skin near the collarbone in a minor surgical procedure. A wire connects the device to your heart.