4th May 2025

An 85-year-old man with a past medical history of asthma, hypertension and previous cerebrovascular accidents has been admitted to the ward.

An 85-year-old man with a past medical history of asthma, hypertension and previous cerebrovascular accidents has been admitted to the ward. He now complains of breathlessness and palpitations. On assessing the patient, he is alert and can communicate with you. He denies chest pain and basic observation reveals a heart rate of 155 bpm and a blood pressure of 150/90. Clinically his lung bases are clear, and you also note he has bilateral carotid bruits on auscultation. His ECG reveals a regular narrow complex tachycardia consistent with SVT. Vagal manoeuvres failed to cardiovert him. 

Which of the following is the most appropriate intervention to undertake?

Select the SINGLE most appropriate option from the list below. Select ONE option only.