Recommendations for acute treatment of wide QRS tachycardia in infants and children
| Wide QRS tachycardia . | Drug/intervention (dosages see Table 1). . | Class . | Level . |
|---|---|---|---|
| Wide QRS tachycardia of unknown mechanism | Electrical cardioversion | I | C |
| Lidocaine iv bolus starting at 1 mg/kg (up to 3 doses in 10 min interval); followed by infusion of 20–50 μg/kg/min | IIa | C | |
| Amiodarone iv loading: 5–10 mg/kg over 60 min, followed by maintenance infusion of 10 mg/kg/day (5–15 μg/kg/min). | IIb | ||
| Procainaimide iv | IIb | ||
| Esmolol iv bolus 500 μg/kg | IIb | ||
| Magnesium sulphate iv | IIb | ||
| Antidromic tachycardia, pre-excited AF | Electrical cardioversion | I | B |
| Flecainide iv | IIa | C | |
| SVT with bundle branch block | See table for acute treatment of SVT | ||
| Monomorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Lidocaine iv | |||
| Sotalol iv | |||
| Polymorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Deep sedation or general anesthesia | IIb | C | |
| Potassium and magnesium iv. | IIb | C |
| Wide QRS tachycardia . | Drug/intervention (dosages see Table 1). . | Class . | Level . |
|---|---|---|---|
| Wide QRS tachycardia of unknown mechanism | Electrical cardioversion | I | C |
| Lidocaine iv bolus starting at 1 mg/kg (up to 3 doses in 10 min interval); followed by infusion of 20–50 μg/kg/min | IIa | C | |
| Amiodarone iv loading: 5–10 mg/kg over 60 min, followed by maintenance infusion of 10 mg/kg/day (5–15 μg/kg/min). | IIb | ||
| Procainaimide iv | IIb | ||
| Esmolol iv bolus 500 μg/kg | IIb | ||
| Magnesium sulphate iv | IIb | ||
| Antidromic tachycardia, pre-excited AF | Electrical cardioversion | I | B |
| Flecainide iv | IIa | C | |
| SVT with bundle branch block | See table for acute treatment of SVT | ||
| Monomorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Lidocaine iv | |||
| Sotalol iv | |||
| Polymorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Deep sedation or general anesthesia | IIb | C | |
| Potassium and magnesium iv. | IIb | C |
iv, intravenously; Class, recommendation class; Level, level of evidence; AF, atrial fibrillation; SVT, supraventricular tachycardia.
Recommendations for acute treatment of wide QRS tachycardia in infants and children
| Wide QRS tachycardia . | Drug/intervention (dosages see Table 1). . | Class . | Level . |
|---|---|---|---|
| Wide QRS tachycardia of unknown mechanism | Electrical cardioversion | I | C |
| Lidocaine iv bolus starting at 1 mg/kg (up to 3 doses in 10 min interval); followed by infusion of 20–50 μg/kg/min | IIa | C | |
| Amiodarone iv loading: 5–10 mg/kg over 60 min, followed by maintenance infusion of 10 mg/kg/day (5–15 μg/kg/min). | IIb | ||
| Procainaimide iv | IIb | ||
| Esmolol iv bolus 500 μg/kg | IIb | ||
| Magnesium sulphate iv | IIb | ||
| Antidromic tachycardia, pre-excited AF | Electrical cardioversion | I | B |
| Flecainide iv | IIa | C | |
| SVT with bundle branch block | See table for acute treatment of SVT | ||
| Monomorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Lidocaine iv | |||
| Sotalol iv | |||
| Polymorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Deep sedation or general anesthesia | IIb | C | |
| Potassium and magnesium iv. | IIb | C |
| Wide QRS tachycardia . | Drug/intervention (dosages see Table 1). . | Class . | Level . |
|---|---|---|---|
| Wide QRS tachycardia of unknown mechanism | Electrical cardioversion | I | C |
| Lidocaine iv bolus starting at 1 mg/kg (up to 3 doses in 10 min interval); followed by infusion of 20–50 μg/kg/min | IIa | C | |
| Amiodarone iv loading: 5–10 mg/kg over 60 min, followed by maintenance infusion of 10 mg/kg/day (5–15 μg/kg/min). | IIb | ||
| Procainaimide iv | IIb | ||
| Esmolol iv bolus 500 μg/kg | IIb | ||
| Magnesium sulphate iv | IIb | ||
| Antidromic tachycardia, pre-excited AF | Electrical cardioversion | I | B |
| Flecainide iv | IIa | C | |
| SVT with bundle branch block | See table for acute treatment of SVT | ||
| Monomorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Lidocaine iv | |||
| Sotalol iv | |||
| Polymorphic ventricular tachycardia | Electrical cardioversion | I | C |
| Propranolol iv | IIb | C | |
| Deep sedation or general anesthesia | IIb | C | |
| Potassium and magnesium iv. | IIb | C |
iv, intravenously; Class, recommendation class; Level, level of evidence; AF, atrial fibrillation; SVT, supraventricular tachycardia.
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
