Narrow Complex Tachycardia Stable

Regular

■ Valsalva maneuver: Instruct Pt to cough, or bare down.

■ Adenosine: 6 mg rapid IV push (1–3 sec) followed with 20 mL NS flush. May repeat 12 mg every 1–2 min. Max 30 mg.

Rhythm Converts	Rhythm Does Not Convert
■ Most likely reentry SVT. ■ Use adenosine for recurrence or longer acting AV nodal blocking agents such as diltiazem or beta-blockers.	■ Most likely A-flutter, ectopic atrial or junctional tachycardia. ■ Control rate with diltiazem or beta-blockers.

Irregular

■ Most likely A-fib/flutter or multifocal atrial tachycardia

(MAT).

■ Control rate with diltiazem or beta-blockers—avoid when associated with Wolff-Parkinson-White Syndrome (WPW).