13
Figure 7. Ongoing Management of AVNRT
AVNRT
YES
Clinical follow-up
without treatment
(Class IIa)
Slow-pathway
catheter ablation
(Class I)
Reassess
symptoms
during follow-up
No or
minimally
symptomatic
Symptomatic
Ablation
candidate, pt
prefers ablation
YES
NO
Beta blockers,
diltiazem, or verapamil
(Class I)
Flecainide or propafenone
(in the absence of SHD)
(Class IIa)
Amiodarone, digoxin,
dofetilide, or sotalol
(Class IIb)
If ineffective
If ineffective,
consider ablation
If ineffective,
consider ablation
Self-administration
of beta blockers,
diltiazem, or
verapamil in pts
with infrequent,
well-tolerated
episodes of AVNRT
(Class IIb)
