Ongoing Management: Recommendations 5.Atrioventricular Nodal Reentrant Tachycardia See Figure 12 for the algorithm for acute treatment of AVNRT and Figure 13 for the algorithm for ongoing management of AVNRT. AVNRT is the most common SVT. It is usually seen in young adults without structural heart disease or ischemic heart disease, and >60% of cases are observed in women.49 The ventricular rate is often 180 bpm to 200 bpm but ranges from 110 bpm to >250 bpm (and in rare cases, the rate can be Miscellaneous Ivabradine 5 mg BID 7.5 mg BID Phosphenes, AF Concomitant drugs that can exacerbate bradycardia Contraindicated in decompensated HF Contraindicated if BP <90/50 mmHg Contraindicated in severe hepatic impairment Hypertension Ivabradine is a substrate of CYP3A4 (major) Avoid use with concomitant strong CYP3A4 inhibitors (boceprevir, clarithromycin, indinavir, itraconazole, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir, telaprevir, posaconazole, voriconazole) Avoid use with strong CYP3A4 inducers (carbamazepine, phenytoin, rifampin, St. John s wort) Avoid use with diltiazem, verapamil, grapefruit juice Note: For this reference table, drugs are presented in alphabetical order within the drug classes, not by COR and LOE. *When 1 drug is used in combination with other drugs, appropriate dosing adjustments should be made with consideration of at least additive effects during dosage titration. All potential drug drug interactions and adverse reactions are not included in this list. For a more detailed list of drug interactions and adverse responses, clinicians should consult additional resources; for example, www.crediblemeds.org may be consulted for potential prolongation of the QT interval. QTc calculation used the Bazett s Formula in most clinical studies. Recommended given in conjunction with a beta blocker or nondihydropyridine calcium channel antagonist. 