High-dose adenosine for refractory supraventricular tachycardia: a case report and literature review

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Critical Care Medicine

Background:

• Supraventricular tachycardia (SVT) is a common significant arrhythmia in children.
• Prolonged SVT can lead to heart failure and cardiogenic shock, necessitating prompt intervention.
• Standard treatments include vagal maneuvers, intravenous adenosine, and electrical cardioversion for unstable patients.

Observation:

• An infant presented with unstable supraventricular tachycardia.
• The infant's condition was refractory to electrical cardioversion.
• Recommended doses of intravenous adenosine were also ineffective.

Findings:

• A higher-than-standard dose of adenosine was administered to the infant.
• The infant reverted to sinus rhythm following the administration of the higher adenosine dose.
• This suggests potential efficacy of increased adenosine dosage in refractory pediatric SVT.

Implications:

• Higher doses of adenosine may be a viable treatment option for refractory supraventricular tachycardia in infants.
• This finding could alter current treatment protocols for pediatric cardiac emergencies.
• Further research is warranted to establish safety and efficacy of higher-dose adenosine in pediatric refractory SVT.