The effect of patient weight on the success of converting sinus rhythm in patients with PSVT treated with standard dose adenosine

• Published in: The American journal of emergency medicine Vol. 69; pp. 28 - 33
• Main Authors: Çorbacioğlu, Şeref Kerem, Uzunosmanoglu, Hüseyin, Karaarslan, Fatma Nur, Dağar, Seda, Emektar, Emine, Çevik, Yunsur
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2023; Elsevier Limited
• Subjects: Ablation; Adenosine; Anti-Arrhythmia Agents - therapeutic use; Cardiac arrhythmia; Catheters; Diagnosis; Electrocardiography; Emergency medical care; emergency medicine; Hospitals; Humans; kilogram; Medical records; Patients; Retrospective Studies; Sinuses; Success; supraventricular tachycardia; SVT; Tachycardia; Tachycardia, Paroxysmal - drug therapy; Tachycardia, Supraventricular - diagnosis; Variables; Weight; SVT; adenosine; supraventricular tachycardia; kilogram; emergency medicine
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2023.03.060

The study aimed to investigate whether there is a difference in the amount of adenosine per kilogram (mg/kg) between the patient groups that can and cannot be converted to sinus rhythm (SR) with adenosine therapy in patients with supraventricular tachycardia (SVT). This single-centered, retrospectively designed study was conducted in the ED of a training and research hospital between December 1, 2019 and December 1, 2022 on patients who were admitted to the ED with SVT diagnosis and treated with a 6–12–18 mg adenosine protocol. The main analyses were carried out in three stages. The first analysis was performed considering the first 6 mg dose of adenosine administered. The second analysis was performed by considering the 12 mg adenosine administered as the second dose because it did not respond to the first dose. Finally, the third analysis was performed by considering the 18 mg adenosine administered as the third dose because it did not respond to preciously dosages. The primary outcome variable was determined to be converting SR and created two groups according to this; the success SR group and the failure SR group. During the study period, 73 patients who were admitted to the ED with PSVT diagnosis and treated with intravenous adenosine were included. After the first 6 mg of adenosine treatment was administered to all 73 patients, SR was achieved in only 38% of patients. The mean adenosine dose (mg/kg) was significantly lower in the failure SR group, 0.07373 ± 0.014, compared with 0.08885 ± 0.017 mg/kg in the success SR group (mean difference with 95% CI: −0.01511 [−0.023 to −0.0071]; p < 0.001). In the second and third stage analyses, considering 12 and 18 mg adenosine doses, when the administrations with successful and failed SR were compared, no difference was found in terms of the applied adenosine doses per kilogram. This study suggest that the success of terminating SVT with the first 6 mg dose of adenosine appears to be dependent on patient weight. In patients given larger doses of adenosine, determinants of PSVT termination success may be factors other than patient weight.