Successful Intraosseous (IO) Adenosine Administration for the Termination of Supraventricular Tachycardia (SVT) in a 3.5-Year-Old Child-Case Report and Literature Review
Jakub Zachaj1, Łukasz Kręglicki2,3, Tomasz Sikora2,4
1Medical Emergency Department, Medical University of Warsaw, Litewska 14/16, 00-575 Warsaw, Poland.
Insights
Intraosseous adenosine effectively converted paediatric supraventricular tachycardia (SVT) to normal sinus rhythm (NSR) in a young child. This case highlights the potential of intraosseous administration for treating pediatric SVT when intravenous access is challenging.
Area of Science:
- Pediatric Cardiology
- Emergency Medicine
- Pharmacology
Background:
- Supraventricular tachycardia (SVT) is a significant pediatric arrhythmia potentially leading to heart failure.
- Current guidelines recommend adenosine for stable SVT unresponsive to vagal maneuvers, typically via intravenous (IV) administration.
- Intraosseous (IO) administration of adenosine is a less explored but viable alternative route.
Abstract:
Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient's condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT.
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