psvt with post dilzem effect my question is that.is it possible to treat psvt on clinic base .please give your comments

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psvt, if haemodynamically stable u can manage well even in clinics....but u need to have icu backup and its must....bcoz no one can risk nowadays....In case in psvt if haemodynamically unstable, then u need to Cardiovert the patient starting with 50 joules biphasic...can go up to 150 joules...in unstable pat, No pharmacological therapy...except in VT or VF...

All adenosine b blocker DILZEM are equal. Advantage of adenosine very short t 1/2. So if hypotension it will not worsen clinical status

yes, absolutely true after attaining normal sinus rythm always look for abberancy...if any, then have to go for EP studies followed by RFA

always remember to sedate the patient before DC cardioversion

Yes possible but control tachycardia and do physiological study and look for aberrant pathway if present treat with radio frequency ablation

Adenosine is better option

I agree with Dr Sanjay nema

yes it is possible with some limitation. If pt is hemodynamicaly stable. vagal maneuver can be done. Carotid massage and eye ball gentle rolling can revert SVT many a time.

never try to convert in a clinic setup. if you use adenosine there is a risk of asystole. if you use dilzem there is risk of vpc's which may alter the rhythm. carotid massage though looks good but should be avoided in advance age patient as it carries the risk of dislodgement of atheromatous plaque if any in carotid artery, so the best situation is ICCU.

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