Related Experiment Videos
Adenosine triphosphate treatment for supraventricular tachycardia in infants
D De Wolf1, G Rondia, H Verhaaren
1Department of Paediatrics, University Hospital, Free University of Brussels, Belgium.
Insights
Striadyne, containing adenosine triphosphate (ATP), effectively treats supraventricular tachycardia (SVT) in infants. This study highlights ATP
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Electrophysiology
Background:
- Adenosine is known for its anti-arrhythmic properties.
- Renewed interest exists in using adenosine or adenosine triphosphate (ATP) for supraventricular tachycardia (SVT) termination.
Purpose of the Study:
- To evaluate the efficacy and safety of Striadyne (ATP and nucleosides) in infants under 6 months for SVT treatment.
- To assess the diagnostic value of ATP in pediatric tachycardia.
Main Methods:
- A study involving 22 infants younger than 6 months.
- Administration of Striadyne to assess SVT termination and diagnostic capabilities.
Main Results:
- Striadyne successfully terminated SVT in 17 infants and was diagnostic in 4 others.
- Recurrences of SVT were observed in 10 of the 17 successfully treated infants but were easily managed.
- The study indicated ATP's efficacy in terminating re-entry tachycardias and its diagnostic utility with minimal side effects.
Conclusions:
- Adenosine or ATP may be the preferred treatment for infant junctional tachycardia post-vagal maneuvers.
- Continuous ECG monitoring allows adenosine or ATP to be diagnostic for various SVTs, including wide-complex tachycardia.
- A recommended dose of 0.5-1.0 mg/kg bolus injection prior to transfer to a pediatric cardiology unit is suggested.
Unlabelled:
Adenosine is an endogenous nucleoside acting on coronary perfusion and myocardial conduction. Although the anti-arrhythmic effects of adenosine have been known for decades, interest in the use of adenosine or adenosine triphosphate (ATP- a precursor of adenosine) in termination of supraventricular tachycardia (SVT) has been renewed. We studied the use of Striadyne (ATP and a mixture of other nucleosides including adenosine) in 22 infants younger than 6 months in order to evaluate efficacy and safety of the drug in this particular age group. Striadyne stopped SVT in 17 cases and was diagnostic in another 4 cases. Ten out of 17 successfully converted infants showed one or more reinitiations of SVT, which were easily controlled. The results support the efficacy of ATP for the termination of re-entry types of tachycardia, as well as its diagnostic value and its lack of serious side-effects.
Conclusion:
Adenosine or ATP could be the drug of choice for the treatment of junctional tachycardia in infants after vagal manoeuvres have failed. Provided continuous ECG monitoring is performed during injection, adenosine or ATP may be diagnostic in other types of supraventricular tachycardia and even in wide-complex tachycardia. We suggest a bolus injection of 0.5-1.0 mg/kg to be used prior to transport to the paediatric cardiology unit.