A patient with supraventricular tachycardia (SVT) at a rate of 195/min is developing symptoms of shock and unconsciousness. At this time, what would you recommend?

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In this scenario, the patient is unstable with symptoms of shock and unconsciousness. Vagal stimulation through carotid sinus massage is contraindicated in this situation as it could lead to further decrease in cardiac output and blood pressure. Administration of a strong β-adrenergic agent may increase heart rate and worsen the SVT. Administration of a bolus of intravenous lidocaine is not the first-line treatment for unstable SVT. The best choice in this scenario is synchronous electrical shock (cardioversion) as it can rapidly convert the patient's rhythm and improve their hemodynamic status.

A Patient with Supraventricular Tachycardia (SVT) at a Rate of 195/min