Paroxysmal Supraventricular Tachycardia

Arnold, Casey; Martínez, Cristina González

doi:10.7759/cureus.4883

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…These people need urgent cardioversion if their heartbeat is not in sinus rhythm. If it is found that they are in acceptable sinus tachycardia, the underlying cause must be addressed [4]. Here, we present the case of a patient with unstable PSVT who refused electrical cardioversion at a resource-limited rural hospital in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Digoxin for the Management of Unstable Paroxysmal Supraventricular Tachycardia in a Patient Who Refused Electrical Cardioversion in a Rural Hospital

Kassa,

Amede,

Wubante

et al. 2023

Case Reports in Emergency Medicine

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Background. The most frequent atrioventricular tachycardia in the emergency room is atrioventricular nodal reentrant tachycardia (AVNRT). The first treatment option for ending stable narrow QRS complex SVTs is vagal maneuvers and adenosine. When adenosine or vagal maneuvers fail to change a patient’s rhythm to normal sinus rhythm, long-acting AV nodal-blocking medications, including nondihydropyridine calcium channel blockers (verapamil and diltiazem), flecainide, or beta-blockers, are employed. Electricity (synchronized cardioversion) is the preferred form of treatment for unstable patients. Case Presentation. A 40-year-old male patient presented to the Emergency Department of Dubti General Hospital, the Afar regional state in Ethiopia, with a complaint of shortness of breath, palpitation, extreme fatigue, and chest pain of a day’s duration. His blood pressure was 80/50 mmHg, he had cold extremities and a weak radial pulse, and his apical heart rate was fast, making it difficult to count. His electrocardiogram (ECG) showed paroxysmal supraventricular tachycardia (PSVT) with a heart rate of 200. He was a candidate for electrical cardioversion due to unstable PSVT, but he and his family members refused to give consent. Even though he is not indicated for pharmacologic therapy, none of the commonly used drugs were available at the hospital. We managed him with digoxin, and the outcome was positive. Conclusion. Even though we could not find a clear recommendation regarding the use of digoxin for patients with unstable PSVT (AVNRT), by taking into consideration its negative chronotropic effect and its action to suppress the AV nodal conduction velocity, it may reduce the heart rate, and it can be used as an alternative in such difficult scenarios and a resource-limited setting. But this should be further investigated.

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Section: Introductionmentioning

confidence: 99%

Digoxin for the Management of Unstable Paroxysmal Supraventricular Tachycardia in a Patient Who Refused Electrical Cardioversion in a Rural Hospital

Kassa,

Amede,

Wubante

et al. 2023

Case Reports in Emergency Medicine

View full text Add to dashboard Cite

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Carotid sinus massage: A reconsideration in supraventricular tachycardia

Fatima,

Naeem,

Qurat ul Ain

2024

J Shalamar Med Dent Coll

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Background: Supraventricular tachycardia (SVT) is attributable to the orthodromic re-entry phenomenon when tachycardia is secondary to normal anterograde electrical conduction. Objective: To determine the clinical efficacy of carotid sinus massage in terminating the episode of supraventricular tachycardia and the incidence of adverse events associated with carotid sinus massage. Methods: A Quasi experimental pretest post-test study was conducted in the emergency department of CMH Multan after Institutional ethical approval (13/Trg, ERC no. 22/2024) from 20th March to 15th June 2024. This study involved 200 patients, above 25 years of age, presenting to the emergency department with palpitations. Standard 12 lead electrocardiogram was done to diagnose SVT. After informed consent was obtained, patients were placed supine with the neck slightly extended and turned to the opposite side. Carotid sinus massage (CSM) was done, and patients were retained in the emergency detention room. The efficacy of CSM was assessed by termination of SVT within 30 seconds of CSM and incidence of its adverse events was noted during or 1 hour after the CSM procedure. Results: The mean age of study participants was 35.55±8.6 years and the majority were females (59.5%). The CSM was successful in terminating SVT in 18.5% of the patients. The frequency of adverse events of CSM was dizziness (3.5%), vomiting (2.5%), syncope (1.5%), exacerbation of arrhythmia (3.5%), and temporary neurologic complications (1%). The success rate of CSM was higher in non-diabetic patients (p=0.020) and those reporting within 2 hours of the onset of the first episode of SVT(p=0.000). Conclusion: Carotid sinus massage is an effective and safe intervention for early-on spot management of supraventricular tachycardia.

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Paroxysmal Supraventricular Tachycardia

Cited by 2 publications

References 8 publications

Digoxin for the Management of Unstable Paroxysmal Supraventricular Tachycardia in a Patient Who Refused Electrical Cardioversion in a Rural Hospital

Digoxin for the Management of Unstable Paroxysmal Supraventricular Tachycardia in a Patient Who Refused Electrical Cardioversion in a Rural Hospital

Carotid sinus massage: A reconsideration in supraventricular tachycardia

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