Treatment of Antidromic Atrioventricular Reentrant Tachycardia in the Haemodynamically Stable Patient
This protocol addresses the management of antidromic atrioventricular re-entrant tachycardia when the patient presents in a haemodynamically stable condition. The specific arrhythmia pattern and the patient's haemodynamic status together determine the appropriate treatment pathway.
Clinical scenario
A haemodynamically stable patient presenting with antidromic atrioventricular re-entrant tachycardia. Haemodynamic stability in this setting permits a stepwise pharmacological approach before escalation.
Treatment approach
Pharmacological conversion is central to the management of this presentation. Intravenous therapy is the primary route, and one antiarrhythmic agent may be considered when the arrhythmia proves refractory to initial measures. The complete structured protocol — including agent selection, sequencing, and decision points — is available via the link below.
References
DOI: 10.1093/eurheartj/ehz467
In antidromic AVRT, i.v. ibutilide or procainamide or i.v. flecainide or profanenone or synchronized DC cardioversion should be considered if vagal manoeuvres and adenosine fail.
In antidromic AVRT, i.v. amiodarone may be considered in refractory cases.
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