12
Treatment
Table 9. Acute Treatment of AVNRT
COR
LOE Recommendations
I B-R Vagal maneuvers are recommended for acute treatment in
patients with AVNRT.
I B-R Adenosine is recommended for acute treatment in patients with
AVNRT.
I B-NR Synchronized cardioversion should be performed for acute
treatment in hemodynamically unstable patients with AVNRT
when adenosine and vagal maneuvers do not terminate the
tachycardia or are not feasible.
I B-NR Synchronized cardioversion is recommended for acute treatment
in hemodynamically stable patients with AVNRT when
pharmacological therapy does not terminate the tachycardia or is
contraindicated.
IIa B-R IV beta blockers, diltiazem, or verapamil are reasonable for acute
treatment in hemodynamically stable patients with AVNRT.
IIb C-LD Oral beta blockers, diltiazem, or verapamil may be reasonable
for acute treatment in hemodynamically stable patients with
AVNRT.
IIb C-LD IV amiodarone may be considered for acute treatment in
hemodynamically stable patients with AVNRT when other
therapies are ineffective or contraindicated.
