The FDA approved Milestone Pharmaceuticals’ nasally administered emergency treatment Cardamyst (etripamil) for a form of acute arrhythmia, after the drug was previously denied twice. The clearance grants a new non‑invasive option for rapid rhythm control outside the hospital. Milestone’s approval follows additional data and regulatory engagement addressing earlier concerns about efficacy and safety. Cardamyst’s intranasal route targets fast systemic absorption for emergent rhythm termination, which could alter emergency‑care pathways for selected supraventricular tachycardias. Clinicians and emergency services will evaluate real‑world logistics, training, and use criteria; payers and hospitals will track cost and adoption compared with established intravenous and procedural interventions.