Mr. Lauer et al., EFFICACY OF ADENOSINE IN TERMINATING CATECHOLAMINE-DEPENDENT SUPRAVENTRICULAR TACHYCARDIA, The American journal of cardiology, 73(1), 1994, pp. 38-42
The purpose of this study was to determine if adenosine is equally eff
ective in terminating catecholamine-dependent and independent supraven
tricular tachycardia (SVP). The effect of adenosine on termination of
SVT was studied in 21 patients: 12 with atrioventricular (AV) reciproc
ating tachycardia, and 9 with AV node reentrant tachycardia. Group 1 c
omprised 13 patients who had SVT induced in the absence of exogenous c
atechol- amines, whereas group 2 comprised 8 who needed isoproterenol
(1.6 +/- 0.4 mu g/min) for induction. There was no statistical differe
nce between the 2 groups regarding age, weight, mean arterial pressure
during sinus rhythm and SVT, cycle length of SVT, or norepinephrine a
nd epinephrine levels during sinus rhythm and SVT. Cycle length during
sinus rhythm was significantly decreased in group 2. The mean dose of
adenosine needed to terminate SVT was 52 +/- 6 mu g/kg of body weight
in group 1, and 61 +/- 12 mu g/kg in group 2 (p >0.05). In addition t
o isoproterenol not altering the minimal dose of adenosine necessary t
o terminate SVT, there was also no correlation between the dose of ade
nosine (mean 55 +/- 6 mu g/kg) of each patient, and the corresponding
endogenous epinephrine (273 +/- 59 pg/ml) (r = -0.19) and norepinephri
ne (400 +/- 58 pg/ml) (r = 0.01) levels during SVT, or cycle length of
SVT (323 +/- 9 ms) (r = -0.35). The results show that adenosine is eq
ually effective in terminating catecholamine-dependent pendent and ind
ependent SVT; higher adenosine doses should not be needed to manage ca
techolamine-dependent SVT. In addition, the results suggest that adeno
sine may exert its effects on AV node conduction primarily through its
effects on adenosine-sensitive potassium channels.