Treatment of Wolff-Parkinson-White Syndrome in Orthodromic Atrioventricular Re-entrant Tachycardia — Haemodynamically Stable Patient

This protocol covers the acute treatment of Wolff-Parkinson-White (WPW) syndrome when it manifests as orthodromic atrioventricular re-entrant tachycardia (AVRT) in a patient who remains haemodynamically stable.

Clinical scenario: Orthodromic atrioventricular re-entrant tachycardia in a haemodynamically stable patient — no haemodynamic instability present.
Treatment approach: When vagal manoeuvres do not terminate the arrhythmia, the protocol directs use of a specific intravenous pharmacological agent. The complete agent selection, dosing algorithm, and sequencing are detailed in the full structured protocol.
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References

DOI: 10.1093/eurheartj/ehz467

In orthodromic AVRT, adenosine (6-18 mg i.v. bolus) is recommended if vagal manoeuvres fail and the tachycardia is orthodromic.

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