Keeping It “Current”: A Review of Treatment Options for the Management of Supraventricular Tachycardia

Tednes, Patrick; Marquardt, Samantha; Kuhrau, Shannon; Heagler, Kristin; Rech, Megan

doi:10.1177/10600280231199136

Cited by 3 publications

(1 citation statement)

References 59 publications

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“…Moreover, in isolated ventricular myocytes, it inhibits the peak Ca 2+ current through Ca V 1.2 channels. Qualitatively similar results were obtained with verapamil, a well-known Ca V 1.2 channel blocker used in therapy for the treatment of hypertension and cardiac arrhythmias [34,44,45]. Taken together, these results indicate that in non-rat hearts, NRB shows a pharmacodynamic profile consistent with the blockade of Ca V 1.2 channels, analogous to what has been observed in rat aorta, in non-rat arteries, and in rat and non-rat non-vascular smooth muscles (see above).…”

Section: In Vivo Ex Vivo and In Vitro Effects Of Norbormide On Non-ra...supporting

confidence: 61%

The Enigma of Norbormide, a Rattus-Selective Toxicant

Fusi,

Saponara,

Brimble

et al. 2024

Cells

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Norbormide (NRB) is a Rattus-selective toxicant, which was serendipitously discovered in 1964 and formerly marketed as an eco-friendly rodenticide that was deemed harmless to non-Rattus species. However, due to inconsistent efficacy and the emergence of second-generation anticoagulants, its usage declined, with registration lapsing in 2003. NRBs’ lethal action in rats entails irreversible vasoconstriction of peripheral arteries, likely inducing cardiac damage: however, the precise chain of events leading to fatality and the target organs involved remain elusive. This unique contractile effect is exclusive to rat arteries and is induced solely by the endo isomers of NRB, hinting at a specific receptor involvement. Understanding NRB’s mechanism of action is crucial for developing species-selective toxicants as alternatives to the broad-spectrum ones currently in use. Recent research efforts have focused on elucidating its cellular mechanisms and sites of action using novel NRB derivatives. The key findings are as follows: NRB selectively opens the rat mitochondrial permeability transition pore, which may be a factor that contributes to its lethal effect; it inhibits rat vascular KATP channels, which potentially controls its Rattus-selective vasoconstricting activity; and it possesses intracellular binding sites in both sensitive and insensitive cells, as revealed by fluorescent derivatives. These studies have led to the development of a prodrug with enhanced pharmacokinetic and toxicological profiles, which is currently undergoing registration as a novel efficacious eco-sustainable Rattus-selective toxicant. The NRB-fluorescent derivatives also show promise as non-toxic probes for intracellular organelle labelling. This review documents in more detail these developments and their implications.

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Section: In Vivo Ex Vivo and In Vitro Effects Of Norbormide On Non-ra...supporting

confidence: 61%

The Enigma of Norbormide, a Rattus-Selective Toxicant

Fusi,

Saponara,

Brimble

et al. 2024

Cells

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Safety of Adenosine for Pediatric Tachyarrhythmia Treatment in the Emergency Department: a Multi-Hospital 10-year Cross-Sectional Study

Randall,

Burt,

Cruise

et al. 2024

Preprint

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Background Supraventricular tachycardia is the most common dysrhythmia in children. Initial vagal maneuvers are successful less than half of the time. Adenosine, a potent AV nodal blocker with short half-life, is recommended as first line pharmacotherapy. Minor side effects from adenosine are common, but report of serious side effects such as sustained ventricular tachycardia, torsades de pointes, syncope or hypotension are confined to small case series or studies greater than 20 years old. We aimed to specifically identify the incidence of serious side effects of adenosine in children in the emergency department. Methods Between 2002 and 2022, all children less than 18 years old who received adenosine for tachyarrhythmia treatment in one of two emergency departments were included. The electronic record was reviewed for demographic information, patient history, treatments given, and side effects or complications were observed. Electrocardiograms before, during and after adenosine administration were reviewed. Results 77 patients met inclusion criteria. There were 73 patients with an initial rhythm of typical SVT. The other four patients included one with SVT with aberrancy, one with a junctional rhythm, one with atrial fibrillation, and one with an undetermined narrow complex tachycardia. 50 patients had cardiac rhythm monitoring during adenosine administration. 17 of these patients had three or more consecutive ventricular beats following adenosine, however no patients required treatment. No patients had syncope. One patient had brief hypotension after adenosine that normalized without intervention. Four patients were electrically cardioverted due to persistent SVT. Twelve patients were placed on continuous antiarrhythmic medication for persistent SVT. The patient with atrial fibrillation remained in atrial fibrillation despite adenosine and electrical cardioversion three times. The patient with undetermined tachycardia had no response to adenosine or amiodarone, then had brief cardiac arrest after intubation. Echocardiography showed heart failure. Conclusions Adenosine treatment in typical supraventricular tachycardia in pediatric patients is safe.

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Evaluating antiarrhythmic drugs for managing infants with supraventricular tachycardia; a review

Mojahedi

2024

Am J Cardiovasc Dis

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Keeping It “Current”: A Review of Treatment Options for the Management of Supraventricular Tachycardia

Cited by 3 publications

References 59 publications

The Enigma of Norbormide, a Rattus-Selective Toxicant

The Enigma of Norbormide, a Rattus-Selective Toxicant

Safety of Adenosine for Pediatric Tachyarrhythmia Treatment in the Emergency Department: a Multi-Hospital 10-year Cross-Sectional Study

Evaluating antiarrhythmic drugs for managing infants with supraventricular tachycardia; a review

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