MRCP Part 1
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Specialty Certificate Examination in Endocrinology and Diabetes
Specialty Certificate Examination in Gastroenterology
GP ST Stage 2 Knowledge Test
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MRCPCH Foundation of Practice and Theory and Science of Practice
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MRCPCH Part 2
MRCPCH Foundation of Practice
Obs and Gynae
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MRCS Part A Papers 1 and 2
FRCS General Surgery
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A 39-year-old man presented to hospital complaining of
palpitations. He felt nauseated and faint but did not have any
chest pain or breathlessness.
He had been diagnosed with Wolff-Parkinson-White syndrome two
years previously and had frequent attacks of palpitations that were
usually terminated by carotid sinus massage which he performed
himself. However, on this occasion carotid sinus massage had failed
to terminate the palpitations.
He had a past history of asthma, treated with salbutamol and
budesonide inhalers. His only other past history was of a fractured
femoral shaft following a road traffic accident three years
previously. He was a non-smoker and had no family history of
ischaemic heart disease.
On examination he appeared well. His blood pressure was 130/75
mmHg and pulse 160 beats per minutes. His heart sounds were normal
and chest clear on auscultation. Abdominal and neurological
examinations were unremarkable.
The 12-lead ECG showed a supra-ventricular tachycardia with a
rate of 160 beats per minutes.
What is the best treatment that should be given to stop the SVT
as carotid sinus massage has been ineffective?
(Please select 1 option)