14
Treatment
Table 10. Ongoing Management of AVNRT
COR
LOE Recommendations
I B-R Oral verapamil or diltiazem is recommended for ongoing
management in patients with AVNRT who are not candidates
for, or prefer not to undergo, catheter ablation.
I B-NR Catheter ablation of the slow pathway is recommended in
patients with AVNRT.
I B-R Oral beta blockers are recommended for ongoing management in
patients with AVNRT who are not candidates for, or prefer not
to undergo, catheter ablation.
IIa B-R Flecainide or propafenone is reasonable for ongoing management
in patients without SHD or ischemic heart disease who have
AVNRT and are not candidates for, or prefer not to undergo,
catheter ablation and in whom beta blockers, diltiazem, or
verapamil are ineffective or contraindicated.
IIa B-NR Clinical follow-up without pharmacological therapy or ablation
is reasonable for ongoing management in minimally symptomatic
patients with AVNRT.
IIb B-R Oral sotalol or dofetilide may be reasonable for ongoing
management in patients with AVNRT who are not candidates
for, or prefer not to undergo, catheter ablation.
IIb B-R Oral digoxin or amiodarone may be reasonable for ongoing
treatment of AVNRT in patients who are not candidates for, or
prefer not to undergo, catheter ablation.
IIb C-LD Self-administered ("pill-in-the-pocket") acute doses of oral beta
blockers, diltiazem, or verapamil may be reasonable for ongoing
management in patients with infrequent, well-tolerated episodes
of AVNRT.
