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Tachyarrhythmias

Clinical features
Investigations
Therapy
Prevention
Prognosis
Prevention

Paroxysmal atrial flutter

Consider 

  • radiofrequency ablation a
  • long-term anti-arrhythmic therapy in symptomatic cases d

    Start medication in hospital a  

Consider using one of

  • flecainide - at least 50 mg twice daily a  
  • sotalol - at least 120 mg twice daily a  

 

Paroxysmal supraventricular tachycardia

Consider anti-arrhythmic medication for patients with recurrent symptomatic arrhythmias.  d  
Start medication in hospital a  

Consider using one of

  • flecainide 50 mg twice daily a  
  • sotalol 80 mg or 160 mg bd po a  
  • propafenone 600 mg b  

 

Ventricular arrhythmias

Consider
  • amiodarone a  
  • inserting an implantable defibrillator a  with endocardial leads b  
    • Consider adding one of
      • amiodarone b  
      • metoprolol a  
      • sotalol a  
There is no clear benefit from
  • propafenone d  
  • allocating therapy using electrophysiologic testing d  
  • surgery (subendocardial resection and left ventricular endoaneurysmorrhaphy) c  

Expiry date: July 2004
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   H   Oral
CAT Writers   CM   Ball , N   Shenker , CJ   Wotton