Supraventricular Tachycardia — RACP Paediatrics MCQ

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ModerateCardiologySupraventricular TachycardiaRACP Paediatrics

A 10-year-old presents with palpitations and a heart rate of 220 beats/min with narrow QRS complexes on ECG. Blood pressure is stable. Vagal manoeuvres have failed. What is the most appropriate next step?

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Correct answer: D — IV adenosine 0.1 mg/kg rapid bolus

For stable supraventricular tachycardia (SVT) unresponsive to vagal manoeuvres, IV adenosine is first-line. The initial dose is 0.1 mg/kg (maximum 6 mg) as a rapid push followed by saline flush. If unsuccessful, the dose can be increased to 0.2 mg/kg (maximum 12 mg). IV verapamil is contraindicated in children under 1 year and should be used with caution in older children.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Supraventricular Tachycardia