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Disorder	Treatment*
Narrow complex tachycardias
Multifocal atrial extrasystoles	Reassurance, a non-dihydropyridine calcium channel blockers, or a beta-blocker
Atrial fibrillation	Anticoagulation For rate control: Beta-blockers Verapamil Diltiazem Digoxin For rhythm control: Antiarrhythmic medications (eg, ibutilide, amiodarone, propafenone, dronedarone, sotalol, dofetilide) Cardioversion Radioablation Sometimes a Maze procedure
Atrial flutter	Anticoagulation Radioablation (often the best treatment) Sometimes DC cardioversion, digoxin, beta blocker, and/or verapamil
Ectopic supraventricular tachycardia (eg, atrial tachycardia)	Sometimes, DC cardioversion, rate control medications (excluding digoxin) , antiarrhythmics, overdrive pacing, and/or ablation
Reentrant supraventricular tachycardias (eg atrioventricular nodal reentrant tachycardia)	Vagotonic maneuvers AV nodal blocking medications (eg, beta blockers, verapamil) Ablation (often the best treatment)
Broad complex tachycardias
Ventricular tachycardia	Immediate pharmacotherapy or DC cardioversion Amiodarone, sotalol, propafenone, lidocaine, mexiletine, flecainide, radioablation Sometimes an implanted defibrillator
Torsade de pointes	If unstable, immediate DC cardioversion, magnesium, and/or potassium; sometimes an implanted defibrillator Ongoing treatment as needed with magnesium, potassium, a beta-blocker, isoproterenol, or overdrive cardiac pacing Sometimes an implanted defibrillator
Ventricular fibrillation	Defibrillation Sometimes medications (eg, amiodarone) Sometimes an implanted defibrillator
Brugada syndrome	Usually DC cardioversion or an implanted defibrillator
* Always identify and correct causes and exacerbating factors (eg, electrolyte abnormalities, hypoxemia, drugs).
AV = atrioventricular; DC = direct current.