Ornato J P
Circulation. 1986 Dec;74(6 Pt 2):IV108-10.
Three forms of treatment are available for patients with paroxysmal supraventricular tachycardia (PSVT): nonpharmacologic, pharmacologic, and electrical. Nonpharmacologic treatments increase vagal tone and include the traditional carotid sinus massage and Valsalva maneuver as well as head-down tilt, activation of the diving reflex, and use of the pneumatic antishock garment. The most effective currently available pharmacologic agent is verapamil. Hemodynamically stable patients whose PSVTs are refractory to verapamil may be treated with digitalis. Patients with antegrade accessory pathway conduction (such as those with Wolff-Parkinson-White syndrome) and a history of atrial fibrillation should be treated with intravenous procainamide if they are hemodynamically stable and with synchronized electrical countershock if they are hemodynamically unstable. Synchronized electrical countershock is the treatment of choice for hemodynamically unstable patients.
阵发性室上性心动过速（PSVT）患者有三种治疗方式：非药物治疗、药物治疗和电治疗。非药物治疗可增强迷走神经张力，包括传统的颈动脉窦按摩、瓦尔萨尔瓦动作，以及头低位倾斜、激发潜水反射和使用气动抗休克衣。目前最有效的药物是维拉帕米。PSVT对维拉帕米难治的血流动力学稳定患者可用洋地黄治疗。有前向性旁路传导（如预激综合征患者）且有房颤病史的患者，若血流动力学稳定，应静脉注射普鲁卡因胺治疗；若血流动力学不稳定，则应进行同步电复律治疗。同步电复律是血流动力学不稳定患者的首选治疗方法。
