Intravenous adenosine in termination of paroxysmal supraventricular tachycardia

AIM: To assess the safety and efficacy of intravenous adenosine in terminating acute episodes of paroxysmal supraventricular tachycardia. METHODS: Twenty-two consecutive hospitalized patients with a tachycardia electrocardiographically consistent with paroxysmal supraventricular tachycardia, received sequential intravenous adenosine of 3, 6, 12, and 18 mg until the termination of supraventricular tachycardia. The patients underwent electrophysiology within 1 wk after the study ended. The two patients without AVRT or AVNRT were excluded from the efficacy analysis. RESULTS: The intravenous adenosine successfully terminated acute episodes of paroxysmal supraventricular tachycardia in 25 %, 65 %, 85 %, and 95 % of patients who received maximum doses of 3, 6, 12, and 18 mg, respectively, in a four dose sequence. The repeatability is excellent. Adenosine caused adverse reactions in 30 % of patients, but they lasted less than 2 min and were usually mild or moderate. CONCLUSION: Intravenous adenosine in graded doses rapidly and effectively terminates acute episodes of paroxysmal supraventricular tachycardia. Adverse reactions to adenosine are common but mostly tolerable.