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Supraventricular Tachycardia — EECC MCQ

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EasyArrhythmia & ElectrophysiologySupraventricular TachycardiaEECC

A 45-year-old woman presents to the emergency department with palpitations and a regular narrow-complex tachycardia at 180 bpm. Blood pressure is 120/80 mmHg. She is fully conscious and has no chest pain. Vagal manoeuvres have failed to terminate the tachycardia. What is the first-line pharmacological treatment?

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Correct answer: C — Intravenous adenosine 6 mg rapid bolus

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · A = shown as D · C = shown as E

For a haemodynamically stable regular narrow-complex tachycardia, intravenous adenosine is the first-line pharmacological treatment after failure of vagal manoeuvres. Initial dose is 6 mg rapid IV bolus, followed by 12 mg if ineffective. Verapamil (A) is second-line. Amiodarone (C) is not first-line for SVT. Flecainide (D) is for AF/flutter. Metoprolol (E) may slow rate but is less effective at terminating re-entrant SVT.

Reference: Resuscitation Council UK (2021): Adult Tachycardia Algorithm