Adenosine for wide-complex tachycardia: efficacy and safety

Area of Science:

• Cardiology
• Electrophysiology
• Emergency Medicine

Background:

• The etiology of sustained monomorphic wide QRS complex tachycardia is often uncertain.
• Accurate diagnosis is crucial for appropriate management.

Purpose of the Study:

• To evaluate the diagnostic and therapeutic utility of adenosine in patients with undifferentiated wide QRS complex tachycardia.
• To assess the safety profile of adenosine in this patient population.

Main Methods:

• Retrospective observational study of 197 patients treated with adenosine for regular wide QRS complex tachycardia.
• Analysis of rhythm response to adenosine and adverse events.
• Determination of adenosine's accuracy in differentiating supraventricular tachycardia from ventricular tachycardia.

Main Results:

• Adenosine demonstrated a high response rate: 90% for supraventricular tachycardia and 2% for ventricular tachycardia.
• A positive response significantly increased the odds of supraventricular tachycardia (36-fold).
• No primary adverse events were observed in either supraventricular tachycardia or ventricular tachycardia groups.

Conclusions:

• Adenosine is a safe and effective diagnostic tool for wide QRS complex tachycardia.
• Adenosine aids in differentiating supraventricular tachycardia from ventricular tachycardia, guiding therapeutic decisions.