What to do about paroxysmal tachycardia

For those without organic heart disease and without obvious heart failure, the attack can be terminated by excitation of the vagus nerve, stimulation of the pharynx, stimulation of the child’s pharynx with a tongue depressor or fingers to produce nausea and vomiting in the baby, allowing the child to hold his breath after deep inhalation, and if this is not effective, compression of the carotid sinus method and the diving reflex method can be used. When the above methods are ineffective or immediately effective, but soon the attack, you can consider the application of drug therapy, such as digitalis drugs, for more serious conditions, the attack lasts more than 24 hours, with the manifestation of heart failure, for ventricular tachycardia or digitalis poisoning caused by supraventricular tachycardia should be prohibited. It should be used with caution in cases of hypokalemia, myocarditis, paroxysmal supraventricular tachycardia with atrioventricular block and renal hypoperfusion. Beta-blockers can also be used and may be indicated for severe AV block, and are contraindicated in the presence of asthma and heart failure. Selective calcium antagonists can be used, which can inhibit the entry of calcium ions into the cells with significant efficacy, with adverse effects of decreased blood pressure and significant negative inotropic effects, and are contraindicated in infants less than 1 year of age. Electrotherapy can be applied, and when individual drug therapy is not effective, especially when hemodynamic instability is present, in addition to digitalis intoxication, DC synchronization, electric shock transient rhythm, transesophageal, atrial pacing or transvenous, intraventricular pacing to terminate supraventricular tachycardia can be used if available. Radiofrequency ablation can also be used, and can be considered for drug therapy that is ineffective, frequent episodes, reversal type, and atrioventricular fold type. In conclusion, if the tachycardia attacks with low blood pressure and the patient is in poor spirits, 120 needs to be called as soon as possible; in addition, if the attacks are frequent, radiofrequency ablation therapy may be required.