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Adenosine in the treatment of supraventricular tachycardia: 5 years of experience (2002-2006)

Abstract We report a retrospective analysis of 5 years of adenosine use in our emergency department (2002-2006). We treated 454 patients with an intravenous bolus of adenosine. The cohort was made up of 40.7% men and 59.3% women, with mean age of 47.32 years, mean heart rate of 162.48 beats per minu...

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Published in:The American journal of emergency medicine 2008-10, Vol.26 (8), p.879-882
Main Authors: Riccardi, Alessandro, MD, Arboscello, Eleonora, MD, Ghinatti, Maria, MD, Minuto, Pierangela, MD, Lerza, Roberto, MD
Format: Article
Language:English
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Summary:Abstract We report a retrospective analysis of 5 years of adenosine use in our emergency department (2002-2006). We treated 454 patients with an intravenous bolus of adenosine. The cohort was made up of 40.7% men and 59.3% women, with mean age of 47.32 years, mean heart rate of 162.48 beats per minute. Among them, 73% responded immediately to the 6-mg dose, 15% responded after the second 12-mg dose, and 11% responded to a further 12-mg dose, whereas 11% were unresponsive. We observed minor side effects in a high percentage of patients (ie, chest tightness 83%, flushing 39.4%, sense of impending death 7%). Only 1 major adverse effect was recorded, that is, administering 12 mg of adenosine induced a marked acceleration in the ventricular rate of a patient with an undiagnosed atrial flutter, caused by induction of atrioventricular conduction (1:1). Our results confirm that when patients are appropriately selected, adenosine is probably the best available drug to treat paroxysmal supraventricular tachycardias, especially in emergency situations.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2007.11.029