Supraventricular arrhythmias

Inappropriate sinus tachycardia

Diagnosis of exclusion

Paroxysmal SVT

It is not associated with IHD

Tx

1st line - Carotid message; if to avoid (e.g carotid bruit, Sx), try valsalva manuvre

If failed, IV adenosine bolus f/by saline flush

6 mg- > if failed, then

12mg -> if failed, then

18 mg

If adenosine is contraindicated (e.g Asthma) in SVT, use Verapamil

Use a large cannula and a large (e.g. antecubital) vein. Remember to:

• check for contraindications such as asthma.
• warn the patient that they will feel unwell and experience chest discomfort for a few seconds after the injection.
• record the ECG continuously (preferably multi-lead) during the injection.

Best long-term Mx: Radiofrequency catheter ablation

Multifocal Atrial Tachycardia (MAT)