Paediatric treatment

The arrythmia can occasionally be terminated by vagal stimulation:

• in the infant, elicit the dive reflex by immersing its face in ice-cold water
• in the child, the Valsalva manoeuvre, carotid massage and orbital pressure may be effective

In an emergency, DC cardioversion is indicated.

Anti-arrhythmic drugs include:

• in the infant: adenosine or flecainide
• in the child: verapamil
• digoxin is effective, but slow (and should NOT be used in the Wolff-Parkinson-White syndrome)

Longterm prophylaxis:

• digoxin
• beta-blockers