Related Experiment Video
Updated: Jun 6, 2026
08:56
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Adenosine Dose and Cardioversion in Pediatric Supraventricular Tachycardia: A Systematic Review and Meta-Analysis
Laís Dos Santos1, Thaís Martins Shehan2, Candela Lang3
1Universidade Federal do Ceará, Fortaleza, Brazil. dralaisdossantos@gmail.com.
Pediatric Cardiology
|June 5, 2026
Summary
Higher weight-based adenosine doses improve cardioversion success for pediatric supraventricular tachycardia (SVT). Current initial doses may be suboptimal, indicating a need for trials on optimized adenosine dosing strategies in children.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Clinical Trials
Background:
- Adenosine is the recommended first-line treatment for pediatric supraventricular tachycardia (SVT).
- Optimal weight-based dosing of adenosine for effective cardioversion in children remains unclear.
- Current dosing strategies may not consistently achieve successful first-pass cardioversion.
Purpose of the Study:
- To investigate the relationship between weight-based adenosine dosage and the probability of cardioversion in pediatric patients with SVT.
- To determine if higher adenosine doses are associated with improved conversion rates.
- To provide evidence for optimizing adenosine dosing protocols in pediatric SVT management.
Main Methods:
- A systematic review and meta-analysis of observational studies was conducted.
- Searches were performed in PubMed, Embase, Scopus, and Cochrane Library up to July 2025.
- Data from 9 studies involving 480 patients and 1,369 adenosine bolus administrations were analyzed using a three-level random-effects model.
Main Results:
- Cardioversion probability increased with higher weight-based adenosine doses.
- Conversion rates ranged from 25% at <100 µg/kg to 59% at 250-400 µg/kg.
- Increasing adenosine dose was significantly associated with higher odds of successful cardioversion (OR per 100 µg/kg = 1.72).
Conclusions:
- Higher weight-based adenosine doses are consistently linked to improved cardioversion probability in pediatric SVT.
- Existing initial adenosine doses might be insufficient for many pediatric patients.
- Further prospective trials are warranted to evaluate mechanism-specific initial dosing strategies for adenosine in children.
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
01:25Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
01:23Cardiopulmonary Resuscitation III: AED Use
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...