Rosh Pediatrics Practice Exam

What therapy is most effective long-term for paroxysmal supraventricular tachycardia in a healthy teenager?

1. Adenosine

2. Atenolol

3. Radiofrequency catheter ablation

4. Synchronized cardioversion under sedation

The correct answer is: Radiofrequency catheter ablation

For a healthy teenager experiencing paroxysmal supraventricular tachycardia (PSVT), the most effective long-term therapy is radiofrequency catheter ablation. This procedure targets and destroys abnormal electrical pathways in the heart that lead to PSVT, providing a curative option for many individuals. Given that PSVT can often be recurrent and significantly impact quality of life, ablation not only addresses the immediate episodes but can prevent future occurrences altogether. While other treatments like adenosine and beta-blockers (such as atenolol) may offer some short-term relief or control of episodes, they do not provide a permanent fix and may require ongoing management. Synchronized cardioversion is typically reserved for immediate management of more severe or symptomatic tachycardias rather than as a long-term treatment strategy. Thus, for sustained benefit and to reduce the risk of recurrence in a healthy adolescent, radiofrequency catheter ablation stands out as the most effective long-term therapy for this condition.