Supraventricular tachycardia AHA recommendations for Management of Suspected Focal Atrial Tachycardia: Difference between revisions
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==Overview== | ==Overview== | ||
Intravenous beta blockers, diltiazem, or verapamil is useful for acute treatment in hemodynamically stable patients with focal AT. Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically unstable focal AT. Catheter ablation is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy.<ref name="pmid26409259">{{cite journal| author=Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ et al.| title=2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2016 | volume= 67 | issue= 13 | pages= e27-e115 | pmid=26409259 | doi=10.1016/j.jacc.2015.08.856 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26409259 }} </ref> | |||
==Management of Suspected Focal Atrial Tachycardia== | ==Management of Suspected Focal Atrial Tachycardia== | ||
2015 AHA recommendations for the acute and ongoing management of suspected [[focal atrial tachycardia]] are described below:<ref name="pmid26409259">{{cite journal| author=Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ et al.| title=2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2016 | volume= 67 | issue= 13 | pages= e27-e115 | pmid=26409259 | doi=10.1016/j.jacc.2015.08.856 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26409259 }} </ref> | |||
===Acute treatment of Suspected Focal Atrial Tachycardia=== | ===Acute treatment of Suspected Focal Atrial Tachycardia=== | ||
{|class="wikitable" style="width:80%" | {|class="wikitable" style="width:80%" | ||
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|colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Intravenous beta blockers, diltiazem, or verapamil is useful for acute treatment in hemodynamically stable patients with focal AT (<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Intravenous [[beta blockers]], [[diltiazem]], or [[verapamil]] is useful for acute treatment in hemodynamically stable patients with focal AT (<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically unstable focal AT(<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''[[Synchronized cardioversion]] is recommended for acute treatment in patients with hemodynamically unstable focal AT(<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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|colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Adenosine can be useful in the acute setting to either restore sinus rhythm or diagnose the tachycardia mechanism in patients with suspected focal AT <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''[[Adenosine]] can be useful in the acute setting to either restore sinus rhythm or diagnose the tachycardia mechanism in patients with suspected focal AT <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Intravenous amiodarone may be reasonable in the acute setting to either restore sinus rhythm or slow the ventricular rate in hemodynamically stable patients with focal A <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Intravenous [[amiodarone]] may be reasonable in the acute setting to either restore sinus rhythm or slow the ventricular rate in hemodynamically stable patients with focal A <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''Ibutilide may be reasonable in the acute setting to restore sinus rhythm in hemodynamically stable patients with focal AT( <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''[[Ibutilide]] may be reasonable in the acute setting to restore sinus rhythm in hemodynamically stable patients with focal AT( <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
|} | |} | ||
===Management of ongoing Suspected Focal Atrial Tachycardia=== | ===Management of ongoing Suspected Focal Atrial Tachycardia=== | ||
{|class="wikitable" style="width:80%" | {|class="wikitable" style="width:80%" | ||
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|colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Catheter ablation is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy ( <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''[[Catheter ablation]] is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy ( <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''Flecainide or propafenone can be effective for ongoing management in patients without structural heart disease or ischemic heart disease who have focal AT<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''[[Flecainide]] or [[propafenone]] can be effective for ongoing management in patients without structural heart disease or ischemic heart disease who have focal AT<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Oral sotalol or amiodarone may be reasonable for ongoing management in patients with focal AT <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Oral [[sotalol]] or amiodarone may be reasonable for ongoing management in patients with focal AT <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Latest revision as of 15:47, 27 October 2016
Supraventricular tachycardia Microchapters |
Differentiating Among the Different Types of Supraventricular Tachycardia |
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Differentiating Supraventricular Tachycardia from Ventricular Tachycardia |
Diagnosis |
Treatment |
2015 ACC/AHA Guideline Recommendations |
Case Studies |
Supraventricular tachycardia AHA recommendations for Management of Suspected Focal Atrial Tachycardia On the Web |
American Roentgen Ray Society Images of Supraventricular tachycardia AHA recommendations for Management of Suspected Focal Atrial Tachycardia |
Directions to Hospitals Treating Supraventricular tachycardia |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Intravenous beta blockers, diltiazem, or verapamil is useful for acute treatment in hemodynamically stable patients with focal AT. Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically unstable focal AT. Catheter ablation is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy.[1]
Management of Suspected Focal Atrial Tachycardia
2015 AHA recommendations for the acute and ongoing management of suspected focal atrial tachycardia are described below:[1]
Acute treatment of Suspected Focal Atrial Tachycardia
Class I |
"1.Intravenous beta blockers, diltiazem, or verapamil is useful for acute treatment in hemodynamically stable patients with focal AT ("(Level of Evidence: C-LD) " |
"2.Synchronized cardioversion is recommended for acute treatment in patients with hemodynamically unstable focal AT("(Level of Evidence: C-LD) " |
Class IIa |
"1.Adenosine can be useful in the acute setting to either restore sinus rhythm or diagnose the tachycardia mechanism in patients with suspected focal AT "(Level of Evidence: B-NR) " |
Class IIb |
"1.Intravenous amiodarone may be reasonable in the acute setting to either restore sinus rhythm or slow the ventricular rate in hemodynamically stable patients with focal A "(Level of Evidence:C-LD) " |
"2.Ibutilide may be reasonable in the acute setting to restore sinus rhythm in hemodynamically stable patients with focal AT( "(Level of Evidence: C-LD) " |
Management of ongoing Suspected Focal Atrial Tachycardia
Class I |
"1.Catheter ablation is recommended in patients with symptomatic focal AT as an alternative to pharmacological therapy ( "(Level of Evidence: B-NR) " |
Class IIa |
"1.Oral beta blockers, diltiazem, or verapamil are reasonable for ongoing management in patients with symptomatic focal AT "(Level of Evidence: C-LD) " |
"2.Flecainide or propafenone can be effective for ongoing management in patients without structural heart disease or ischemic heart disease who have focal AT"(Level of Evidence: C-LD) " |
Class IIb |
"1.Oral sotalol or amiodarone may be reasonable for ongoing management in patients with focal AT "(Level of Evidence:C-LD) " |
References
- ↑ 1.0 1.1 Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ; et al. (2016). "2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". J Am Coll Cardiol. 67 (13): e27–e115. doi:10.1016/j.jacc.2015.08.856. PMID 26409259.