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. One small study randomized patients with SVT to digoxin (0.375 mg/day), propranolol (240 mg/day), or verapamil (480 mg/day), with 1 week of placebo washout between drug regimens.99 Reduction in the number of episodes and duration of SVT (ascertained by diary and weekly 24-h Holter) was similar among the treatment groups, and all 3 medications were well tolerated.99 I B-NR 2. EP study with the option of ablation is useful for the diagnosis and potential treatment of SVT.36,100 106 See Online Data Supplement 2. EP testing with the option of ablation is useful as first-line therapy for treatment of symptomatic SVT, as it provides the potential for definitive cure without the need for chronic pharmacological therapy. Large registry studies report high success rates for ablation of both AVNRT and AVRT, with low frequency of potentially serious complications (Table 8). I C-LD 3. Patients with SVT should be educated on how to perform vagal maneuvers for ongoing management of SVT.82 See Online Data Supplement 2. When properly performed, vagal maneuvers can terminate SVT, so patient education on this maneuver may help to avoid a more prolonged tachycardia episode and reduce the need to seek medical attention. Vagal maneuvers should be performed with the patient in the supine position. 