In this section
12 lead ECG showing regular narrow complex tachycardia.
Consult cardiology urgently if tachycardia is broad complex or
Vagal manoeuvres. Valsalva if child old enough; gag or
icepack/iced water for infants - apply to face for a maximum of 30
seconds. Do not use eyeball pressure.
Should be administered only by experienced
The recorded strip at the time of conversion to sinus rhythm
should be inspected and saved, for concealed pre-excitation which
may only be revealed during the first few beats after conversion to
sinus rhythm. After a patient has been reverted a 12 lead ECG
should be performed to look for pre-excitation and other
Rapid re-initiation of tachycardia is not uncommon, mostly due
to premature atrial contractions stimulated by the adenosine. If
this occurs consider trying adenosine again.
Side effects including flushing and chest tightness/discomfort
are not uncommon. These are usually brief and transient. Rarely
atrial fibrillation or prolonged pauses may occur.
Adenosine is contra-indicated in adenosine-deaminase deficiency
(rare immune deficiency) and patients taking dypyridamole
(Persantin). Care is required in asthma, as it may cause
If these measures fail to revert the
SVT, consult Cardiology.
A follow up plan should be made in consultation with
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