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<unk>  tachycardia (SVT). This is known as the oculocardiac reflex. Medications Termination of<unk>  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<unk>  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.
Paroxysmal supraventricular tachycardia
Wandering atrial pacemaker
Inappropriate sinus tachycardia
Ventricular escape beat
Junctional ectopic tachycardia
AV nodal reentrant tachycardia
Atrioventricular reentrant tachycardia
Accelerated idioventricular rhythm