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Amiodarone and Adenosine for Pediatric Supraventricular Tachycardia: A Systematic Review

Hector I Guerra Toro1, Arturo P Jaramillo2, Valeria M Caceres3

  • 1General Physician, Pontificia Universidad Catolica del Ecuador, Quito, ECU.

Cureus
|December 11, 2023
PubMed

Insights

Adenosine is recommended for acute management of supraventricular tachycardia (SVT) in pediatric patients, while amiodarone shows promise for chronic control. Combined therapies may offer better outcomes for pediatric SVT management.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Clinical Literature Review

Background:

  • Supraventricular tachycardia (SVT) management in pediatric patients lacks standardized first- or second-line treatments.
  • Drug effectiveness for SVT in children and infants (1 hour to 17 years) with no structural heart disease varies significantly.

Purpose of the Study:

  • To review and synthesize current literature on amiodarone and adenosine for managing SVT in pediatric patients.
  • To identify optimal pharmacological strategies and highlight areas for future research in pediatric SVT treatment.

Main Methods:

  • Systematic literature review (SLR) following PRISMA guidelines.
  • Searches conducted across PubMed, PubMed Central, Google Scholar, Web of Science, and The Cochrane Library.
  • Inclusion of 10 scholarly articles, including systematic reviews, meta-analyses, and randomized controlled trials.

Main Results:

  • Adenosine is recommended for acute management and as a first-line option for paroxysmal SVT due to its short half-life and safety profile.
  • Amiodarone demonstrated effectiveness, particularly when administered 48 hours post-diagnosis, and is recommended for junctional ectopic tachycardia (JET) prophylaxis and chronic control.
  • No significant adverse effects were documented; side effects were mild and manageable. Combined amiodarone and adenosine therapies showed promising results.

Conclusions:

  • Both amiodarone and adenosine are effective in converting pediatric SVT to sinus rhythm, with combined therapies potentially yielding superior outcomes.
  • Further randomized clinical trials and meta-analyses are needed to standardize pharmacological treatment for pediatric SVT.

Keywords:
adenosineamiodaronedrug therapeuticssupraventricular tachycardiapediatric

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