Description
Contributor: Travis Barlock, MD
Educational Pearls:
SVT: supraventricular tachycardia
Pharmacotherapy for SVT includes drugs that block the AV node, such as adenosine
EKG criteria before adenosine administration in SVT
Regular rhythm
Monomorphic: all QRS complexes are identical
If the EKG is polymorphic, with QRS complexes displaying changing morphologies, it is unsafe to administer adenosine
Adenosine can worsen polymorphic VTach and lead to VFib
References
Ganz, Leonard I., and Peter L. Friedman. “Supraventricular Tachycardia.” New England Journal of Medicine, vol. 332, no. 3, 19 Jan. 1995, pp. 162–173, https://doi.org/10.1056/nejm199501193320307.
Smith JR, Goldberger JJ, Kadish AH. Adenosine induced polymorphic ventricular tachycardia in adults without structural heart disease. Pacing Clin Electrophysiol. 1997;20(3 Pt 1):743-745. doi:10.1111/j.1540-8159.1997.tb03897.x
Viskin, Sami, et al. “Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy.” Circulation, vol. 144, no. 10, 7 Sept. 2021, pp. 823–839, https://doi.org/10.1161/circulationaha.121.055783.
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