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AVNRT — RACP Adult Medicine MCQ

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EasyCardiologyAVNRTRACP Adult Medicine

A 35-year-old man presents with recurrent episodes of rapid palpitations lasting 10–30 minutes that terminate spontaneously. ECG during an episode shows a narrow complex regular tachycardia at 180 bpm. Vagal manoeuvres transiently slow the rate then the tachycardia abruptly terminates. What is the most likely diagnosis?

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Correct answer: D — AV nodal re-entrant tachycardia (AVNRT)

A narrow complex regular tachycardia that terminates abruptly with vagal manoeuvres (or adenosine) is characteristic of AV nodal re-entrant tachycardia (AVNRT) – the most common paroxysmal SVT. The re-entrant circuit uses dual AV nodal pathways. Acute treatment is vagal manoeuvres followed by IV adenosine (6 mg rapid bolus, then 12 mg). For recurrent episodes, catheter ablation (>95% success rate) is definitive. Beta-blockers or verapamil are alternatives for prophylaxis.

Reference: eTG – 2025 – Cardiovascular; ESC – 2019 – SVT Guidelines