In this case, the vagal maneuvers did not result in a change. What is the next step in managing this condition?

When managing a patient with supraventricular tachycardia (SVT) who does not respond to vagal maneuvers, the next appropriate step is to administer adenosine. Adenosine is a rapid-acting antiarrhythmic agent that can effectively terminate certain types of SVT by briefly blocking the conduction of electrical impulses through the atrioventricular (AV) node. This action can interrupt the reentrant pathways that are often responsible for this tachycardia and help restore normal sinus rhythm.

The administration of adenosine is typically safe and can provide immediate results, making it a preferred choice when vagal maneuvers fail. It is worth noting that the use of adenosine is particularly suited for situations where patients experience stable SVT, as it provides a quick and effective method for management in an acute setting.

While observation, beta-blocker therapy, and scheduling for an electrophysiology study can be relevant in the overall management of SVT, they are not the immediate next steps when an acute intervention is required to address a symptomatic episode. Observation may delay necessary treatment, and while beta-blockers might be appropriate for long-term management of recurrent SVT, they are not typically the first line in an