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Adenosine in the management of supraventricular tachycardia in children
M C Sherwood1, K C Lau, G F Sholler
1Adolph Basser Cardiac Institute, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia.
Insights
Adenosine effectively manages supraventricular tachycardia (SVT) in children, with a 75% reversion rate. A starting dose of 0.1 mg/kg is recommended for this safe and effective treatment.
Area of Science:
- Pediatric Cardiology
- Clinical Pharmacology
Background:
- Supraventricular tachycardia (SVT) is a common arrhythmia in children.
- Adenosine is a widely used antiarrhythmic agent.
Purpose of the Study:
- To evaluate the efficacy and safety of adenosine for treating SVT in pediatric patients.
- To determine the optimal starting dose of adenosine for children.
Main Methods:
- Retrospective review of 43 pediatric patients with SVT treated with intravenous adenosine.
- Data collected on reversion rates, recurrence, side effects, and diagnostic use.
Main Results:
- Adenosine achieved a 75% reversion rate to sinus rhythm across all SVT episodes.
- Patients with re-entrant SVT showed a 96% reversion rate.
- Common side effects were transient discomfort; no serious adverse events were reported.
Conclusions:
- Adenosine is a safe and effective treatment for pediatric supraventricular tachycardia.
- An initial dose of 0.1 mg/kg is suggested for optimal therapeutic outcomes.
Objective:
To assess the efficacy and safety of adenosine in the management of supraventricular tachycardia in children.
Methodology:
A review of 43 children with supraventricular tachycardia who received intravenous adenosine between June 1992 and July 1995.
Results:
Thirty-five patients had re-entrant supraventricular tachycardia and eight patients had atrial tachydysrhythmias. Reversion to sinus rhythm occurred in 75% of episodes in all patients treated for supraventricular tachycardia, and in 96% of episodes in patients with re-entrant supraventricular tachycardia. Early re-initiation of supraventricular tachycardia after reversion to sinus rhythm occurred in 25% of episodes. Sixteen percent of patients reverted with the recommended 0.05 mg/kg starting dose, and 35% reverted with a dose of 0.1 mg/kg. Four patients were given adenosine as a diagnostic procedure to elicit occult pre-excitation. The most common side effects were brief feelings of discomfort. No serious side effects occurred.
Conclusion:
Adenosine is safe and effective in the management of supraventricular tachycardia in children. A commencing dose of 0.1 mg/kg is appropriate.