Successful conversion of unstable supraventricular tachycardia to sinus rhythm with adenosine

Annals of Emergency Medicine
F R MelioE Newton

Abstract

To evaluate the efficacy of adenosine in the treatment of emergency department patients with unstable paroxysmal supraventricular tachycardia (PSVT). A retrospective chart review conducted over two years. A university-affiliated hospital ED. Patients with unstable PSVT (systolic blood pressure of less than 90 mm Hg, chest pain, pulmonary edema, and/or altered mental status) who were treated with adenosine. Patients' preadenosine and postadenosine heart rates, symptoms, and blood pressure were recorded, as were complications and recurrence of PSVT. PSVT was diagnosed by surface ECG. Twelve patients were identified (three men and nine women with a mean age of 47.6 years). Nine patients presented with hypotension (mean systolic blood pressure, 79 mm Hg), ten with chest pain, and six with both chest pain and hypotension. There were no patients with altered mental status or pulmonary edema. Eight patients converted to sinus rhythm with a single 6-mg bolus of adenosine; the remaining four required an additional 12-mg bolus. In all cases, chest pain and hypotension resolved within minutes of conversion to sinus rhythm. There were no clinically significant adverse effects or recurrence of PSVT during ED observation (mean, 1.8 hours). A...Continue Reading

References

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Citations

Jun 1, 1996·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·W J BradyG Lindbeck
Jun 14, 2008·Emergency Medicine Australasia : EMA·James A Innes
Jul 1, 1994·The American Journal of Emergency Medicine·C A Marco, J F Cardinale
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Nov 2, 2011·Emergency Medicine Clinics of North America·Allan R Mottram, James E Svenson

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