- AVNRT (atrioventricular nodal reentry tachycardia)
- AVRT (atrioventricular reentry tachycardia)
- AT (atrial tachycardia)
Hemodynamically unstable:
- Adenosine 6 mg rapid IV push If no response in 1 minute, repeat with 12 mg rapid IV push
- Cardioversion: If adenosine not effective, proceed with the immediate cardioversion 100J
Hemodynamically stable: Valsalva maneuver, blowing syringe
- Adenosine if Valsalva maneuver not effective, adenosine 6 mg IV push followed by 12 mg if no response in 2 minutes
- Metoprolol: If adenosine not effective, give metoprolol 5 mg IV every 5 minutes max 3 doses 15 mg
- Amiodarone if all of the above fail, give amiodarone bolus 150 mg over 10 minutes, then continue at 1 milligram/minute for 6 hours, followed by 0.5 mg minute for 18 hours
From Current hospital medicine 2023 by Dr. Amyl Rafiq MD
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