Treatment of Symptomatic, Recurrent Atrioventricular Reentrant Tachycardia

Clinical Scenario

This protocol addresses the patient presenting with symptomatic, recurrent atrioventricular re-entrant tachycardia (AVRT) — episodes that are clinically significant and have become a recurring burden. Catheter ablation of the accessory pathway is recommended for this patient population.

Treatment Approach (partial summary)

When catheter ablation is not desirable or feasible, pharmacological rhythm management is the primary alternative. The selection of agent depends on the findings on resting ECG and on the patient's cardiac history — certain classes of rate- and rhythm-controlling agents are indicated under specific conditions.

Full selection criteria, sequencing, and decision algorithm available in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehz467

Catheter ablation of AP(s) is recommended in patients with symptomatic, recurrent AVRT.
Beta-blockers or non-dihydropyridine calcium-channel blockers (verapamil or diltiazem in the absence of HFrEF) should be considered if no signs of pre-excitation are present on resting ECG, if ablation is not desirable or feasible.
Propafenone or flecainide may be considered in patients with AVRT and without ischaemic or structural heart disease, if ablation is not desirable or feasible.

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