Management of<unk>  consists mainly of the treatment of the underlying cause. If treatment is indicated, therapy should begin with first correcting underlying electrolyte abnormalities with the repletion of potassium to maintain greater than 4 mEq/L and magnesium greater than 2 mEq/L. Studies have shown magnesium suppresses ectopic<unk>  activity and can be beneficial even if magnesium levels are within the normal range. Once electrolyte abnormalities have been corrected, possible treatment options include non-dihydropyridine calcium channel blockers, beta-blockers, and atrioventricular (AV) node ablation. Studies have found no role for antiarrhythmic agents, cardioversion, or anticoagulation. In the absence of underlying pulmonary disease, the first-line agent is beta-blockers. A beta-blockers act to suppress ectopic foci by reducing sympathetic stimulation and decreasing conduction through the atrioventricular node, thereby slowing the ventricular response. Studies have found an average decrease in heart rate of 51 beats per minute and 79% of patients reverted to sinus rhythm. Most patients did not need beta-blocker therapy long term as studies found long-term therapy was needed in only 25% of patients. Caution should be used in patients with an underlying pulmonary disease such as COPD and patients with decompensated heart failure due to the increased risk for bronchospasms and decreased cardiac output. Furthermore, beta-blockers should be avoided in patients with atrioventricular blocks unless a pacemaker has been implanted. In the presence of underlying pulmonary disease, the first-line agent is a non-dihydropyridine calcium channel blocker such as verapamil or diltiazem. These agents act to suppress<unk>  rate and decrease conduction through the atrioventricular node, thereby slowing the ventricular rate. Studies have found an average reduction in the ventricular rate of 31 beats per minute and 43% of patients reverted to sinus rhythm. Caution should be used in patients with preexisting heart failure or hypotension due to negative inotropic effects and peripheral vasodilation. Similarly, calcium channel blockers should also be avoided in patients with atrioventricular blocks unless a pacemaker has been implanted. In select cases of refractory<unk> , AV node ablation has been performed. Studies have found an average reduction in the ventricular rate of 56 beats per minute with adequate control of ventricular response in 84% of patients. However, AV node ablation creates a complete heart block and requires the placement of a permanent pacemaker. Administration of oxygen may play a role in the treatment of some patients.
Multifocal atrial tachycardia
Wandering atrial pacemaker
Atrioventricular reentrant tachycardia
AV nodal reentrant tachycardia
Second-degree atrioventricular block
Third-degree atrioventricular block
First-degree atrioventricular block
Sinus arrhythmia