p.49 抽出テキスト

Recommendations for the therapy of multifocal AT Anticoagulation as in AF is recommended for patients with atrial flutter and concomitant AF. I B Acute therapy Haemodynamically unstable patients Synchronized DC cardioversion is recommended for haemodynamically unstable patients. I B Haemodynamically stable patients Intravenous ibutilide or i.v. or oral (in-hospital) dofetilide is recommended for conversion to sinus rhythm in the absence of QTc interval prolongation. I B Low-energy (<_100 J biphasic) electrical cardioversion is recommended for conversion to sinus rhythm. I B High-rate atrial pacing is recommended for termination of atrial flutter in the presence of an implanted pacemaker or defibrillator. I B Long-term therapy Catheter ablation is recommended for symptomatic, recurrent episodes of cavotricuspid isthmus-dependent flutter. I A Catheter ablation in experienced centres is recommended for symptomatic, recurrent episodes of non-CTI-dependent flutter. I B Catheter ablation is recommended in patients with persistent atrial flutter or in the presence of depressed LV systolic function due to tachycardiomyopathy. I B

Recommendations for the management of AVNRT Acute therapy Haemodynamically unstable patients Synchronized DC cardioversion is recommended for haemodynamically unstable patients.86-88 I B Haemodynamically stable patients Vagal manoeuvres, preferably in the supine position with leg elevation, are recommended.41, 89-91 I B Adenosine (618 mg i.v. bolus) is recommended if vagal manoeuvres fail.92-94 I B Synchronized DC cardioversion is recommended when drug therapy fails to convert or control the tachycardia.87, 88 I B Long-term therapy Catheter ablation is recommended for symptomatic, recurrent AVNRT.208, 336-339 I B

Recommendations for the therapy of AVRT due to manifest or concealed APs Acute therapy Haemodynamically unstable patients Synchronized DC cardioversion is recommended for haemodynamically unstable patients. I B Haemodynamically stable patients Vagal manoeuvres, preferably in the supine position with leg elevation, are recommended. I B Adenosine (618 mg i.v. bolus) is recommended if vagal manoeuvres fail and the tachycardia is orthodromic. I B Synchronized DC cardioversion is recommended when drug therapy fails to convert or control the tachycardia. I B Chronic therapy Catheter ablation of AP(s) is recommended in patients with symptomatic, recurrent AVRT. I B

Recommendations for the acute therapy of pre-excited AF Haemodynamically unstable patients Synchronized DC cardioversion is recommended in haemodynamically unstable patients. I B Haemodynamically stable patients Synchronized DC cardioversion is recommended if drug therapy fails to convert or control the tachycardia. I B

Recommendations for the management of patients with asymptomatic pre-excitation Performance of an EPS, with the use of isoprenaline, is recommended to risk stratify individuals with asymptomatic pre-excitation who have high risk occupations/hobbies,c and those who participate in competitive athletics. I B Catheter ablation is recommended in asymptomatic patients in whom electrophysiology testing with the use of isoprenaline identifies high-risk properties, such as SPERRI <_250 ms, AP ERP <_250 ms, multiple APs, and an inducible AP-mediated tachycardia. I B Catheter ablation is recommended in high-risk patients with asymptomatic pre-excitation after discussing the risks, especially of heart block associated with ablation of anteroseptal or mid-septal APs, and benefits of the procedure. I C Invasive risk stratification with an EPS is recommended in patients without “low risk” characteristics at non-invasive risk stratification. I C Downloaded from academic.oup.com/eurheartj/article/41/5/655/5556821 by guest on 07 October 2026