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SVT – infant — RACP Paediatrics MCQ

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ModerateCardiologySVT – infantRACP Paediatrics

A 2-month-old presents with poor feeding and pallor. Heart rate is 280 bpm with a narrow complex tachycardia on ECG. Blood pressure is maintained and the infant is alert. What is the most appropriate initial management?

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Correct answer: A — Vagal manoeuvres

In a haemodynamically stable infant with SVT, vagal manoeuvres (ice to the face/modified dive reflex) are the first-line intervention. If unsuccessful, IV adenosine is the next step. Synchronised DC cardioversion is reserved for haemodynamically unstable patients.

Reference: RCH Melbourne – 2023 – Supraventricular Tachycardia CPG; ANZCOR – 2024 – Paediatric ALS Guidelines