Diagnosis and treatment

Treatment of narrow QRS complex tachycardias with conduction disturbancies.

  1. Vagal maneuvers and carotid sinus massage. This maneuver can interrupt orthodromic tachycardia, nodal reentry tachycardia and sometimes atrial tachycardia. If any, underlying atrial activity will be highlighted.
  2. Adenosine (Krenosine).
  3. Calcium channel blockers: Diltiazem or verapamil (Isoptin).
  4. ß-blockers: Metoprolol (Beloc-Zok), Esmolol (Brevibloc), Propranolol (Inderal).
  5. En cas d'échec on peut administrer de l'amiodarone (Cordarone) par voie i.v.

After restoration of sinus rhythm there are 2 options: maintenance long term medical treatment or catheter ablation.

Particular situation of atrial flutter and atrial fibrillation