Figure 14. Ongoing Management of SVT in ACHD Patients
Beta blockers,
sotalol, and/or
catheter ablation
(Class IIa)
Pre-op or
intra-op ablation
of accessory
pathways or
AT for repair of
Ebstein anomaly
(Class IIa)
Amiodarone,
dofetilide, or
atrial pacing
(Class IIb)
Surgical ablation
for planned
surgical repair
(Class IIa)
Treatment
Assess hemodynamic
abnormalities and
intervention as indicated for
structural defects
(Class I)
Treatment strategies
Table 21. Acute Treatment of SVT in Pregnancy
COR
LOE Recommendations
I C-LD Vagal maneuvers are recommended for acute treatment in
pregnant patients with SVT.
I C-LD Adenosine is recommended for acute treatment in pregnant
patients with SVT.
I C-LD Synchronized cardioversion is recommended for acute treatment
in pregnant patients with hemodynamically unstable SVT when
pharmacological therapy is ineffective or contraindicated.
IIa C-LD IV metoprolol or propranolol is reasonable for acute treatment
in pregnant patients with SVT when adenosine is ineffective or
contraindicated.
IIb C-LD IV verapamil may be reasonable for acute treatment in pregnant
patients with SVT when adenosine and beta blockers are
ineffective or contraindicated.
IIb C-LD IV procainamide may be reasonable for acute treatment in
pregnant patients with SVT.
IIb C-LD IV amiodarone may be considered for acute treatment in
pregnant patients with potentially life-threatening SVT when
other therapies are ineffective or contraindicated.
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