Supraventricular tachycardia AHA recommendations for Management of Junctional Tachycardia

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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, procainamide, or verapamil is reasonable for acute treatment in patients with symptomatic junctional tachycardia. Oral beta blockers, diltiazem or verapamil is reasonable for ongoing management in patients with junctional tachycardia. Flecainide or propafenone may be reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have junctional tachycardia. Catheter ablation may be reasonable in patients with junctional tachycardia when medical therapy is not effective or contraindicated.^[1]

Management of Junctional Tachycardia

2015 AHA recommendations for the management of junctional tachycardia are described below:^[1]

Acute Treatment of Junctional Tachycardia

Class IIa
"1. Intravenous beta blockers are reasonable for acute treatment in patients with symptomatic junctional tachycardia "(Level of Evidence:C-LD ) "
"2. Intravenous diltiazem, procainamide, or verapamil is reasonable for acute treatment in patients with junctional tachycardia "(Level of Evidence:C-LD ) "

Management of ongoing Junctional Tachycardia

Class IIa
"1. Oral beta blockers are reasonable for ongoing management in patients with junctional tachycardia "(Level of Evidence:C-LD) "
"2. Oral diltiazem or verapamil is reasonable for ongoing management in patients with junctional tachycardia "(Level of Evidence:C-LD) "

Class IIb
"1. Flecainide or propafenone may be reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have junctional tachycardia "(Level of Evidence:C-LD) "
"2. Catheter ablation may be reasonable in patients with junctional tachycardia when medical therapy is not effective or contraindicated "(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.

[pmid26409259-1] 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.

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