Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia
Evidence Summaries Level of Evidence = B
Reversion rate of supraventricular tachycardia appears to be similar with adenosine and intravenous calcium channel antagonists.The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).
A Cochrane review 1 included 7 studies with a total of 622 subjects who presented to an emergency department with supraventricular tachycardia (SVT). All studies but one were conducted in adults. There were no differences in the number of people reverting to sinus rhythm between calcium channel antagonists (CCA) and adenosine (92.9% vs 89.7%; OR 1.51, 95% CI 0.85 to 2.68; 7 studies, n=622). No appreciable differences in major adverse event rates between CCAs and adenosine were observed. Only one case of hypotension in the CCA group and none in the adenosine group (0.66% vs 0%; OR 3.09, 95% CI 0.12 to 76.71; 3 studies, n=306) were reported. Three studies reported that chest tightness occurred more frequently among participants treated with adenosine (11.7%) compared with verapamil (0%). Included studies did not report length of stay in hospital nor patient satisfaction.
1. Alabed S, Sabouni A, Providencia R et al. Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Cochrane Database Syst Rev 2017;(10):CD005154. [PMID:29025197]
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