Advances in Antiarrhythmic Drug Therapy: Pharmacologic Management of Supraventricular Tachycardia

Pharmacologic management remains indispensable in supraventricular tachycardia despite ablation's curative potential. In stable patients, vagal maneuvers precede drugs; adenosine's ultrashort action makes it first-line, with intravenous calcium-channel or β-blockers and procainamide selected by QRS morphology and accessory-pathway risk. Chronic suppression relies on atrioventricular-nodal agents or class IC/III drugs selected by cardiac substrate and comorbidities, while special populations demand dose and drug modifications. Emerging self-administered therapies-particularly intranasal etripamil and selective A1 agonists-promise convenient, rapid conversion outside hospital settings. An individualized, guideline-driven strategy balancing efficacy, safety, and patient preference remains central to optimal supraventricular tachycardia care.