Improved First Dose Conversion of Supraventricular Tachycardia Using Weight-Based Adenosine.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia requiring emergency treatment.
• Intravenous adenosine is a standard treatment for PSVT, but its success rates can vary.
• Patient-specific factors influencing adenosine efficacy are not well-defined.

Purpose of the Study:

• To investigate the impact of adenosine dosage, specifically weight-based dosing (≥0.1mg/kg), on the success rate of first-dose conversion for PSVT.
• To identify patient factors affecting adenosine treatment success in PSVT.

Main Methods:

• Retrospective cohort analysis of 76 patients with PSVT treated with intravenous adenosine from November 2015 to March 2020.
• Primary outcome: first-dose adenosine success stratified by weight-based dosage (≥0.1mg/kg vs. <0.1mg/kg).
• Collected baseline characteristics and adverse effects for comparison between groups.

Main Results:

• Patients receiving adenosine at ≥0.1mg/kg demonstrated significantly higher rates of conversion to sinus rhythm compared to those receiving lower doses (p=0.006).
• No significant difference in adverse effects was observed between the higher and lower dose groups (p=0.75).

Conclusions:

• Weight-based adenosine dosing (≥0.1mg/kg) is associated with greater first-dose success in converting PSVT to sinus rhythm.
• This dosing strategy appears safe, with no increased adverse effects compared to lower doses.
• Findings support further investigation via a randomized controlled trial to confirm the effectiveness and safety of weight-based adenosine for PSVT.