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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In the acute setting, for a person with a supraventricular tachycardia or atrial fibrillation, the goal is to slow the rate and establish the diagnosis. Sometimes, attempts will be made to use vagal maneuvers to block the adrenalin forces in the body. One such maneuver asks the patient to hold their breath while bearing down hard as if to have a bowel movement. This stimulates the vagus nerve in the body, increasing the release of the chemical acetylcholine, which affects the heart by slowing it down.

Adenosine may be given as a single intravenous injection that may reset the pacemaker cells and allow the heart to go back into a normal rhythm, or it may slow the heart rate temporarily to allow the doctor to diagnose the underlying heart rhythm causing the rapid heart beat. This allows the appropriate medication to be prescribed for control or cure. Other medications that may be used include beta blockers and calcium channel blockers.

Some rhythms, like Wolfe-Parkinson-White SVT, have specific electrical short circuits that can be treated by the administration of high-frequency electrical energy ("burning") during heart catheterization and using high frequency ultrasound to ablate or destroy the abnormal electrical pathway and cure the problem. This is opportunity is limited to use in a few situations.

If the rapid heart rate is associated with chest pain, shortness of breath, or low blood pressure, an emergent situation exists, and electrical shocks may be administered with anesthesia to convert the heart to a more stable and slower rhythm.

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