Supraventricular tachycardia AHA recommendations for Management of Orthodromic AVRT: Difference between revisions
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==Overview== | ==Overview== | ||
==Management of Orthodromic AVRT== | ==Management of Orthodromic AVRT== | ||
2015 AHA recommendations for the management of the acute and ongoing treatment for the [[orthodromic AVRT]] 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 Orthodromic AVRT=== | ===Acute Treatment of Orthodromic AVRT=== | ||
{|class="wikitable" | {|class="wikitable" stylea"width:80%" | ||
|- | |- | ||
|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]] | ||
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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 of the accessory pathway is recommended in patients with AVRT and/or pre-excited AF<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Catheter ablation of the accessory pathway is recommended in patients with AVRT and/or pre-excited AF<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''Oral beta blockers, diltiazem, or verapamil are indicated for ongoing management of AVRT in patients without | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Oral beta blockers, diltiazem, or verapamil are indicated for ongoing management of AVRT in patients without | ||
pre-excitation on their resting ECG <nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | pre-excitation on their resting ECG <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.'''Oral flecainide or propafenone is reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have AVRT and/or pre-excited AF and are not candidates for, or prefer not to undergo, catheter ablation<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Oral flecainide or propafenone is reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have AVRT and/or pre-excited AF and are not candidates for, or prefer not to undergo, catheter ablation<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 dofetilide or sotalol may be reasonable for ongoing management in patients with AVRT and/or pre-excited | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Oral dofetilide or sotalol may be reasonable for ongoing management in patients with AVRT and/or pre-excited | ||
AF who are not candidates for, or prefer not to undergo, catheter ablation<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-R]])'' <nowiki>"</nowiki> | AF who are not candidates for, or prefer not to undergo, catheter ablation<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-R]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''Oral amiodarone may be considered for ongoing management in patients with AVRT and/or pre-excited AF who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, and verapamil are ineffective or contraindicated<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Oral amiodarone may be considered for ongoing management in patients with AVRT and/or pre-excited AF who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, and verapamil are ineffective or contraindicated<nowiki>"</nowiki>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:C-LD]])'' <nowiki>"</nowiki> | ||
|} | |} |
Revision as of 16:07, 27 October 2016
Supraventricular tachycardia Microchapters |
Differentiating Among the Different Types of Supraventricular Tachycardia |
---|
Differentiating Supraventricular Tachycardia from Ventricular Tachycardia |
Diagnosis |
Treatment |
2015 ACC/AHA Guideline Recommendations |
Case Studies |
Supraventricular tachycardia AHA recommendations for Management of Orthodromic AVRT On the Web |
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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
Management of Orthodromic AVRT
2015 AHA recommendations for the management of the acute and ongoing treatment for the orthodromic AVRT are described below:[1]
Acute Treatment of Orthodromic AVRT
Class I |
"1. Vagal maneuvers are recommended for acute treatment in patients with orthodromic AVRT "(Level of Evidence: B-R) " |
"2. Adenosine is beneficial for acute treatment in patients with orthodromic AVRT "(Level of Evidence: B-R) " |
"3. Synchronized cardioversion should be performed for acute treatment in hemodynamically unstable patients with
AVRT if vagal maneuvers or adenosine are ineffective or not feasible "(Level of Evidence: B-NR) " |
"4. Synchronized cardioversion is recommended for acute treatment in hemodynamically stable patients with AVRT
when pharmacological therapy is ineffective or contraindicated "(Level of Evidence: B-NR) " |
"5. Synchronized cardioversion should be performed for acute treatment in hemodynamically unstable patients with
pre-excited AF"(Level of Evidence: B-NR ) " |
"6. Ibutilide or intravenous procainamide is beneficial for acute treatment in patients with pre-excited AF
who are hemodynamically stable "(Level of Evidence: C-LD) " |
Class IIa |
"1. Intravenous diltiazem, verapamil "(Level of Evidence: B-R) or beta blockers can be effective for acute treatment in patients with orthodromic AVRT who do not have preexcitation
on their resting ECG during sinus rhythm "(Level of Evidence: C-LD) " |
Class IIb |
"1. Intravenous beta blockers, diltiazem, or verapamil might be considered for acute treatment in patients with orthodromic
AVRT who have pre-excitation on their resting ECG and have not responded to other therapies"(Level of Evidence:B-R) " |
Class III(harm) |
"1. Intravenous digoxin, intravenous amiodarone, intravenous or oral beta blockers, diltiazem, and verapamil are
potentially harmful for acute treatment in patients with pre-excited AF ( "(Level of Evidence: C-LD) " |
Management of ongoing Orthodromic AVRT
Class I |
"1. Catheter ablation of the accessory pathway is recommended in patients with AVRT and/or pre-excited AF"(Level of Evidence: B-NR) " |
"2. Oral beta blockers, diltiazem, or verapamil are indicated for ongoing management of AVRT in patients without
pre-excitation on their resting ECG "(Level of Evidence: C-LD) " |
Class IIa |
"1. Oral flecainide or propafenone is reasonable for ongoing management in patients without structural heart disease or ischemic heart disease who have AVRT and/or pre-excited AF and are not candidates for, or prefer not to undergo, catheter ablation"(Level of Evidence: C-LD) " |
Class IIb |
"1. Oral dofetilide or sotalol may be reasonable for ongoing management in patients with AVRT and/or pre-excited
AF who are not candidates for, or prefer not to undergo, catheter ablation"(Level of Evidence:B-R) " |
"2. Oral amiodarone may be considered for ongoing management in patients with AVRT and/or pre-excited AF who are not candidates for, or prefer not to undergo, catheter ablation and in whom beta blockers, diltiazem, flecainide, propafenone, and verapamil are ineffective or contraindicated"(Level of Evidence:C-LD) " |
References
- ↑ 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.