A previously fit and well 52-year-old patient
develops a regular narrow-complex tachycardiain recovery, but is otherwise stable with a blood
pressure of 125/85mmHg. Youapply oxygen on high flow via a facemask, perform a
12-lead ECG and start carotid sinus massage, which fails to correct the tachycardia. You
give adenosine 6mg intravenously,which fails to alter the rhythm, followed by a
further adenosine 12mg intravenously, again with no improvement.What would you do next?
a) Give digoxin 500 mcg intravenously
b) Give amiodarone 300mg loading dose intravenously
c) Give verapamil 2.5mg intravenously over two
minutes
d) Give adenosine 12mg intravenously
e) Perform synchronised DC cardioversion
