6
Treatment
Table 3. Ongoing Management of SVT of Unknown Mechanism
COR
LOE Recommendations
I B-R Oral beta blockers, diltiazem, or verapamil is useful for ongoing
management in patients with symptomatic SVT who do not have
ventricular pre-excitation during sinus rhythm.
I B-NR EP study with the option of ablation is useful for the diagnosis
and potential treatment of SVT.
I C-LD Patients with SVT should be educated on how to perform vagal
maneuvers for ongoing management of SVT.
IIa B-R Flecainide or propafenone is reasonable for ongoing management
in patients without SHD or ischemic heart disease who have
symptomatic SVT and are not candidates for, or prefer not to
undergo, catheter ablation.
IIb B-R Sotalol may be reasonable for ongoing management in patients
with symptomatic SVT who are not candidates for, or prefer not
to undergo, catheter ablation.
IIb B-R Dofetilide may be reasonable for ongoing management in
patients with symptomatic SVT who are not candidates for,
or prefer not to undergo, catheter ablation and in whom beta
blockers, diltiazem, flecainide, propafenone, or verapamil are
ineffective or contraindicated.
IIb C-LD Oral amiodarone may be considered for ongoing management
in patients with symptomatic SVT who are not candidates for,
or prefer not to undergo, catheter ablation and in whom beta
blockers, diltiazem, dofetilide, flecainide, propafenone, sotalol, or
verapamil are ineffective or contraindicated.
IIb C-LD Oral digoxin may be reasonable for ongoing management in
patients with symptomatic SVT without pre-excitation who are
not candidates for, or prefer not to undergo, catheter ablation.
