Safety of adenosine for pediatric tachyarrhythmia treatment in the emergency department: a multi-hospital 10-year cross- sectional study
Dublin Core
Title
Safety of adenosine for pediatric tachyarrhythmia treatment in the emergency department: a multi-hospital 10-year cross- sectional study
Subject
Adenosine, Supraventricular tachycardia, Tachydysrhythmia, Arrhythmia
Description
Abstract
Background Supraventricular tachycardia is the most common dysrhythmia in children. Initial vagal maneuvers are
successful less than half of the time. Adenosine, a potent AV nodal blocker with a short half-life, is recommended as
first line pharmacotherapy. Minor side effects from adenosine are common, but report of serious side effects such as
sustained ventricular tachycardia, torsades de pointes, syncope or hypotension are confined to small case series or
studies greater than 20 years old. We aimed to specifically identify the incidence of serious side effects of adenosine in
children in the emergency department.
Methods Between 2002 and 2022, all children less than 18 years old who received adenosine for tachyarrhythmia
treatment in two emergency departments were included. The electronic record was reviewed for demographic
information, patient history, treatments given, and side effects or complications were observed. Electrocardiograms
before, during and after adenosine administration were reviewed.
Results 77 patients met inclusion criteria. There were 74 patients with an initial rhythm of typical SVT. The other
three patients included one with a junctional rhythm, one with atrial fibrillation, and one with an undetermined
narrow complex tachycardia. 49 patients had cardiac rhythm monitoring during adenosine administration. 17 of
these patients had three or more consecutive ventricular beats following adenosine, however no patients required
treatment. No patients had syncope. One patient had brief hypotension after adenosine that normalized without
intervention. Four patients were electrically cardioverted after adenosine, all for persistent dysrhythmias: two for
persistent SVT with hypotension, one for atrial fibrillation and one for an undetermined rhythm. Twelve patients were
placed on continuous antiarrhythmic medication for persistent SVT. Age, gender, prior SVT history, initial adenosine
dose, and need for additional doses were not significant risk factors for a prolonged sinus pause or greater than two
ventricular beats.
Conclusions Adenosine treatment in typical supraventricular tachycardia in pediatric patients is safe.
Keywords Adenosine, Supraventricular tachycardia, Tachydysrhythmia, Arrhythmia
Background Supraventricular tachycardia is the most common dysrhythmia in children. Initial vagal maneuvers are
successful less than half of the time. Adenosine, a potent AV nodal blocker with a short half-life, is recommended as
first line pharmacotherapy. Minor side effects from adenosine are common, but report of serious side effects such as
sustained ventricular tachycardia, torsades de pointes, syncope or hypotension are confined to small case series or
studies greater than 20 years old. We aimed to specifically identify the incidence of serious side effects of adenosine in
children in the emergency department.
Methods Between 2002 and 2022, all children less than 18 years old who received adenosine for tachyarrhythmia
treatment in two emergency departments were included. The electronic record was reviewed for demographic
information, patient history, treatments given, and side effects or complications were observed. Electrocardiograms
before, during and after adenosine administration were reviewed.
Results 77 patients met inclusion criteria. There were 74 patients with an initial rhythm of typical SVT. The other
three patients included one with a junctional rhythm, one with atrial fibrillation, and one with an undetermined
narrow complex tachycardia. 49 patients had cardiac rhythm monitoring during adenosine administration. 17 of
these patients had three or more consecutive ventricular beats following adenosine, however no patients required
treatment. No patients had syncope. One patient had brief hypotension after adenosine that normalized without
intervention. Four patients were electrically cardioverted after adenosine, all for persistent dysrhythmias: two for
persistent SVT with hypotension, one for atrial fibrillation and one for an undetermined rhythm. Twelve patients were
placed on continuous antiarrhythmic medication for persistent SVT. Age, gender, prior SVT history, initial adenosine
dose, and need for additional doses were not significant risk factors for a prolonged sinus pause or greater than two
ventricular beats.
Conclusions Adenosine treatment in typical supraventricular tachycardia in pediatric patients is safe.
Keywords Adenosine, Supraventricular tachycardia, Tachydysrhythmia, Arrhythmia
Creator
Melanie M. Randall1*, Tristen Burt2
, Scott Cruise2
, Michael K. Mesisca2
and Thomas Minahan2
, Scott Cruise2
, Michael K. Mesisca2
and Thomas Minahan2
Source
https://doi.org/10.1186/s12245-024-00683-5
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Melanie M. Randall1*, Tristen Burt2
, Scott Cruise2
, Michael K. Mesisca2
and Thomas Minahan2, “Safety of adenosine for pediatric tachyarrhythmia treatment in the emergency department: a multi-hospital 10-year cross- sectional study,” Repository Horizon University Indonesia, accessed April 26, 2026, https://repository.horizon.ac.id/items/show/12402.