AV nodal blocking can be achieved in at least three ways: Physical maneuvers A number of physical maneuvers increase the resistance of the AV node to transmit impulses (AV nodal block), principally through activation of the parasympathetic nervous system, conducted to the heart by the vagus nerve. These manipulations are collectively referred to as vagal maneuvers. The Valsalva maneuver should be the first vagal maneuver tried and works by increasing intra-thoracic pressure and affecting baroreceptors (pressure sensors) within the arch of the aorta. It is carried out by asking the patient to hold his/her breath while trying to exhale forcibly as if straining during a bowel movement. Holding the nose and exhaling against the obstruction has a similar effect. Pressing down gently on the top of closed eyes may also bring heartbeat back to normal rhythm for some people with atrial or supraventricular tachycardia (SVT). This is known as the oculocardiac reflex. Medications Termination of PSVT following adenosine administration asprin immediately Adenosine, an ultra-short-acting AV nodal blocking agent, is indicated if vagal maneuvers are not effective. If unsuccessful or the PSVT recurs diltiazem or verapamil are recommended. Adenosine may be safely used during pregnancy. SVT that does not involve the AV node may respond to other anti-arrhythmic drugs such as sotalol or amiodarone. Cardioversion If the person is hemodynamically unstable or other treatments have not been effective, synchronized electrical cardioversion may be used. In children this is often done with a dose of 0.5 to 1 J/Kg.
types of Supraventricular tachycardia
medical cause of Ventricular tachycardia
medical cause of Ventricular fibrillation
symptoms of Brugada syndrome
medical cause of Supraventricular tachycardia
symptom of Brugada syndrome
complications of Atrial fibrillation
symptom of Catecholaminergic polymorphic ventricular tachycardia