Jacek Owczarek, Wojciech Owczarek
Supraventricular tachycardia pharmacotherapy in adults
Treatment of cardiac automacity disorders and conducting disorders in electrical conduction system of the heart is quite wide and very crucial clinical problem. Setting the process of patient treatment demands not only clinical command of ECG chart – what is medical domain – but also the command of drugs availability and effectivity and pharmacotherapeutic limits. Cardiological recommendations according to European Society of Cardiology and Polish Cardiac Society which were lately revised in 2019 year based on literature direct the way of processing into supraventricular tachycardia. In the article there is showed actual information about pharmacotherapy of these kind of automaticity and conduction disorders included effectivity, side effects and availability drugs in Poland in adults. Understanding clinical aspects of effectivity and safety of the antiarrhythmic drugs is as important as command of mechanism of action of the drugs based on the command of action potential of myocardial cells. One of the most important drug from choice in the majority of pacients in treatment of tachycardia with narrow QRS complex in ECG is adenosine. Importance has also drugs blocking adrenergic receptors β1, blockers of Calcium canals (verapamil, diltiazem) and amiodarone. Limits involve I class drugs according to Vogham-William - from that class practical application has only Prokainamid which blocks sodium channel delaying „0” phase of action potential of cellular depolarization and extending time of action potential and propafenon and flekainid (from Ic group) – only delaying „0” phase of action potential of cellular depolarization. Due to luck of large controlled clinical studies in pregnant women there are described cardiological recommendations to get interruption/moderation of supraventricular tachycardia. Discussed recommendations do not involve atrial fibrillations without preexcitation – treatment of atrial fibrillation and atrial flutter are the subject of others cardiological recommendations.
Keywords: supraventricular tachycardia, drug therapy, recommendations.
© Farm Pol, 2022, 78(4): 184–193