What is the first-line treatment for supraventricular tachycardia?

Supraventricular tachycardia (SVT) is characterized by an abnormally fast heart rhythm originating from the atria or the atrioventricular node. The initial management of SVT usually focuses on non-invasive measures, with vagal maneuvers being a primary option.

Vagal maneuvers, such as the Valsalva maneuver or carotid massage, aim to increase parasympathetic tone, which can help slow down the heart rate by affecting the conduction through the AV node. This can terminate the tachycardia by interrupting the reentrant circuit responsible for the SVT. Since these techniques are non-invasive and often effective, they are considered the first-line approach in stable patients with SVT.

Other treatments, such as adenosine infusion and beta-blockers, also play important roles in managing SVT but are generally employed when vagal maneuvers are ineffective or if the patient is experiencing significant symptoms. Cardioversion is typically reserved for unstable patients or those who remain symptomatic despite other treatment options.