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The acute treatment of supraventricular tachycardia.

The diagnosis of supraventricular tachycardia has become much more important with the advent of radiofrequency ablation. This is usually best done at presentation in an acute setting. A 12-lead electrocardiogram should be a routine aid in making the diagnosis. A continuous rhythm strip must be obtained during administration of adenosine and at the termination of tachycardia. Most recent treatment guidelines would include adenosine as first-line therapy. If adenosine fails to restore normal sinus rhythm, diltiazem or a beta blocker should then be considered. If there is significant heart failure, digoxin may be useful. In the presence of wide complexes, agents that produce atrioventricular nodal block should be avoided.