Pharmacologic management of tachycardia

Cardiac arrhythmias may present with palpitations, chest pain, shortness of breath, dizziness and syncope. Diagnosis may be complicated by an inability to document the arrhythmia particularly when symptoms are infrequent and short lived.

This article aims to provide an overview of the pharmacological management of supraventricular tachycardia including atrial flutter and haemodynamically stable ventricular tachycardia. Management of atrial fibrillation is discussed in a companion article in this issue.

Antiarrhythmic medications are effective in reducing symptoms, however, side effects are frequent. Fortunately nonpharmacological strategies such as catheter ablation have evolved which offer long term cure in the majority of patients. However, despite technological advances, pharmacotherapy retains an important place in the therapeutic approach to cardiac arrhythmias in many patients. It is important to remember that pharmacological management should also address any underlying cardiac disease process.