Is Adenosine or an Intravenous Calcium Channel Blocker More Effective for Treating Supraventricular Tachycardia?

Abstract

The search strategy identified 237 new references since the 2006 review, 1 of which 2 new studies were identified that met the inclusion criteria. These were added to 5 studies from the existing review, resulting in 7 total studies comprising 622 participants. Six studies were conducted with adults and one study was conducted with pediatric patients. Verapamil was used in all studies, although one study had both a verapamil and a diltiazem treatment arm.

Unmasking Adenosine: The Purinergic Signalling Molecule Critical to Arrhythmia Pathophysiology and Management

“…56,57 It is therefore advisable that adenosine be avoided if the underlying rhythm is clear from the 12-lead ECG without need for unmasking manoeuvres. 58 In the context of a broad complex tachycardia, where atrial flutter with aberrant conduction is suspected, adenosine is safer to use than a CCA. 59 Several mechanistic studies suggest that atrial flutter is critically dependent on antecedent AF to produce a line of block between the superior and inferior vena cava, allowing re-entry around the cavotricuspid isthmus (CTI).…”

“…[ 56 , 57 ] It is therefore advisable that adenosine be avoided if the underlying rhythm is clear from the 12-lead ECG without need for unmasking manoeuvres. [ 58 ] In the context of a broad complex tachycardia, where atrial flutter with aberrant conduction is suspected, adenosine is safer to use than a CCA. [ 59 ]…”