The Single-Syringe Versus the Double-Syringe Techniques of Adenosine Administration for Supraventricular Tachycardia: A Systematic Review and Meta-Analysis

Miyawaki, Isabele A.; Gomes, Cintia; Moreira, Vittoria Caporal S.; Marques, Isabela Reis; Souza, Isabela A. F. de; Silva, Caroliny H. A.; Júnior, Jorge Elias; Huh, Kangwook; McDowell, Marc; Padrão, Eduardo Messias Hirano; Tichauer, Matthew; Gibson, C. Michael

doi:10.1007/s40256-023-00581-w

Cited by 4 publications

(1 citation statement)

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“…It is typically administered as a 6-mg intravenous bolus administered over 1 to 2 seconds followed by saline flush . A recent meta-analysis of 3 randomized trials and 1 nonrandomized trial (178 patients) showed similar efficacy in terminating PSVT whether adenosine was combined with normal saline and administered through a single syringe (85% terminated PSVT) vs sequential administration in which adenosine was administered first, followed by a saline flush (77% terminated PSVT; odds ratio, 2.08; 95% CI, 0.65-6.64), although the analysis was limited by small sample size . Adenosine administration should be accompanied by a running ECG to facilitate diagnosis of PSVT subtype (Figure 3B) and with electrical cardioversion pads in place.…”

Section: Treatmentmentioning

confidence: 99%

Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

Peng,

Zei

2024

JAMA

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ImportanceParoxysmal supraventricular tachycardia (PSVT), defined as tachyarrhythmias that originate from or conduct through the atria or atrioventricular node with abrupt onset, affects 168 to 332 per 100 000 individuals. Untreated PSVT is associated with adverse outcomes including high symptom burden and tachycardia-mediated cardiomyopathy.ObservationsApproximately 50% of patients with PSVT are aged 45 to 64 years and 67.5% are female. Most common symptoms include palpitations (86%), chest discomfort (47%), and dyspnea (38%). Patients may rarely develop tachycardia-mediated cardiomyopathy (1%) due to PSVT. Diagnosis is made on electrocardiogram during an arrhythmic event or using ambulatory monitoring. First-line acute therapy for hemodynamically stable patients includes vagal maneuvers such as the modified Valsalva maneuver (43% effective) and intravenous adenosine (91% effective). Emergent cardioversion is recommended for patients who are hemodynamically unstable. Catheter ablation is safe, highly effective, and recommended as first-line therapy to prevent recurrence of PSVT. Meta-analysis of observational studies shows single catheter ablation procedure success rates of 94.3% to 98.5%. Evidence is limited for the effectiveness of long-term pharmacotherapy to prevent PSVT. Nonetheless, guidelines recommend therapies including calcium channel blockers, β-blockers, and antiarrhythmic agents as management options.Conclusion and RelevanceParoxysmal SVT affects both adult and pediatric populations and is generally a benign condition. Catheter ablation is the most effective therapy to prevent recurrent PSVT. Pharmacotherapy is an important component of acute and long-term management of PSVT.

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Section: Treatmentmentioning

confidence: 99%