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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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