This ECG does not exclude PJRT or a low septal atrial tachycardia, which can appear very similar to this ECG. AVNRT indicates atrioventricular nodal reentrant tachycardia; ECG, electrocardiogram; and PJRT, permanent form of junctional reciprocating tachycardia. Page et al 2015 ACC/AHA/HRS SVT Guideline e517 2.4.2. Ongoing Management: Recommendations The recommendations and algorithm (Figure 9) for ongoing management, along with other recommendations and algo- rithms for specific SVTs that follow, are meant to include consideration of patient preferences and clinical judgment; this may include consideration of consultation with a car- diologist or clinical cardiac electrophyisiologist, as well as patient comfort with possible invasive diagnostic and therapeutic intervention. Recommendations for treatment options (including drug therapy, ablation, or observation) must be considered in the context of frequency and dura- tion of the SVT, along with clinical manifestations, such as symptoms or adverse consequences (eg, development of cardiomyopathy). Recommendations for Ongoing Management of SVT of Unknown Mechanism COR LOE Recommendations I B-R Oral beta blockers, diltiazem, or verapamil is useful for ongoing management in patients with symptomatic SVT who do not have ventricular pre-excitation during sinus rhythm.46,98,99 See Online Data Supplement 2. Although many patients prefer to undergo potentially curative therapy with ablation, given its high success rate, and although ablation may be mandatory therapy for patients in certain occupations (eg, pilots, bus drivers), patients may prefer not to undergo ablation or may not have access to a cardiac electrophysiologist. In these latter cases, pharmacological therapy with AV nodal blockers is an appropriate option for long-term prophylactic therapy. Pharmacological therapy with verapamil (dosage up to 480 mg/day) has been studied in RCTs, with reductions documented in SVT episode frequency and duration as recorded by Holter monitoring or subjective episode frequency recording in diaries.98 Evidence for beta blockers is limited. 