Figure 8. Acute Treatment of Orthodromic AVRT
Orthodromic AVRT
YES
NO
IV beta blockers,
IV diltiazem, or IV
verapamil
(Class IIa)
IV beta blockers,
IV diltiazem, or IV
verapamil
(Class IIb)
Vagal maneuvers and/or
IV adenosine
(Class I)
Synchronized
cardioversion
(Class I)
If ineffective
or not feasible
Hemodynamically
stable
a
For rhythms that break or recur spontaneously, synchronized cardioversion is not
appropriate.
Treatment
If ineffective
or not feasible
Pre-excitation on
resting ECG
YES
NO
Synchronized
cardioversion
a
(Class I)
16
