Prevention of further episodes of paroxysmal supraventricular tachycardia

Patients who experience only occasional episodes of paroxysmal supraventricular tachycardia generally do not require treatment to prevent further episodes. Refer patients with frequent episodes or pre-excitation (Wolff–Parkinson–White syndrome) to a cardiac electrophysiologist for consideration of electrophysiological study and catheter ablation or drug therapy.

Catheter ablation is considered first-line therapy if treatment is required to prevent further episodes of paroxysmal supraventricular tachycardia. Drug therapy can be used if the patient does not want catheter ablation, or if catheter ablation is contraindicated or not toleratedBrugada 2020.

If drug therapy is considered more appropriate than catheter ablation for frequent episodes of paroxysmal supraventricular tachycardia, usePage 2016Lopez-Sendon 2004:

If catheter ablation is considered inappropriate and the above drug therapy is ineffective, consider referral for other drug therapies (eg sotalol, flecainide, amiodarone).