What should be initially used to treat AVNRT and AVRT?

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Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) are both forms of paroxysmal supraventricular tachycardia that arise from reentry circuits involving the atrioventricular node or accessory pathways. The initial treatment for these conditions typically focuses on immediately slowing down the heart rate and restoring normal rhythm.

Using AV nodal blocking agents is an effective strategy as these medications work by interrupting the conduction through the AV node, thus breaking the reentrant circuit responsible for the tachycardia. Common AV nodal blocking agents include beta-blockers, calcium channel blockers, and adenosine. These agents help to not only decrease the heart rate but also can terminate the tachycardia in many cases, making them a first-line treatment option.

In contrast, while ablation techniques and electrophysiological studies are important tools in the long-term management of AVNRT and AVRT, they are generally reserved for patients with recurrent episodes or cases that are not responsive to pharmacological therapy. Synchronized cardioversion is typically used in emergency settings for more severe or unstable tachyarrhythmias, rather than the initial management

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