medigraphic.com

1998, Number 2

<< Back Next >>

Med Crit 1998; 12 (2)

Adenosine usefulness in the critically ill patient with paroxysmal supraventricular tachycardia (PSVT)

Lázaro-Castillo JL, Huerta-Torrijos J, Sánchez VLD

Language: Spanish
References: 17
Page: 61-64
PDF size: 96.83 Kb.


ABSTRACT

Objective. To evaluate the effectiveness of adenosine in the treatment of paroxysmal supraventricular tachycardia (PSVT) in critically ill patients.
Design. Case series, clinical study.
Setting. Multidisciplinary ICU of a 115-bed general hospital.
Patients. Eleven stable patients (mean age 63.3 ± 19.1 yr) with of ≥ 150 beats per minute and narrow QRS complex.
Interventions. The patients received an initial intravenous bolus of adenosine (6 mg); additional doses of 12 mg (one or two) were given if necessary.
Measurements and main results. Adenosine treatment was effective in two patients but the drug was no usefull in the remainder nine patients. There was no mortality or morbidity related to the use of adenosine.
Conclusion. Adenosine should not be used for all QRS narrow tachycardias as first election drug in multidisciplinary ICUs.


REFERENCES

  1. Akhtar M, Breithardt G, Camm AJ et al. CAST Study. Circulation 1990;81:1123.

  2. Effect of adenosine or adenosine triphospate on antidromic tachycardia. J Am Coll Cardiol 1994;24:728.

  3. Task Force of the Working Group on Arrhythmias of the European Society of Cardiology. The Sicilian Gambit. A New approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Circulation 1991;84:1831.

  4. 4 . Kall JG, Kopp D, Olshansky B et al. Adenosine-sensitive atrial tachycardia. PACE 1995;18. 300.

  5. Burstock G. Purinergic receptors in the heart. Cir Res 1980;46 Suppl I: 175.

  6. Belardinelli L, Isenberg G. Isolated atrial myocytes: adenosine and acetylcholine increase potassium conductance. Am J Physiol 1983;244:H 734.

  7. Brooks R, Raskin JN. Adenosine and the treatment of supraventricular tachycardia. Am J Med 1992;92:655.

  8. Engelstein DE, Lippman N, Stein KM, Lerman BB. Haemodynamic deterioration after treatment with adenosine. British Heart Journal 1994;71:569.

  9. Calkins H et al. Diagnosis and cure of the Wolf-Parkinson-White syndrome on paroxysmal supraventricular tachycardias during a single electrophysiologic test. N Engl J Med 1991;324:1612.

  10. Chen-SA, Chiang-CE, Yang-CJ, Cheng-CC, Wu-TJ, Wang-SP, Chiang-BN, Chang-MS. Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation 1994; 90:1262.

  11. Domanovits H, Laske H, Star KG, Sterz F, Schmidinger H, Schreiber W, Mullner M, Laggner AN. Adenosine for the management of patients with tachycardias -a new protocol. European Heart Journal 1994;15:589.

  12. Rostagn-C, Bertini-G, Padeletti-L, Michelucci-A, Del Pace-S, Gensini-GF. Rational bases for the bases for the therapy of supraventricular tachycardias and their management. Ann Ital Med Int 1993;8:235.

  13. Lauer-MR, Young-C, Liem-LB, Sung-RJ. Efficacy of adenosine in terminating catecholamine dependent supraventricular tachycardia. Am J Cardiol 1994;1:73:38.

  14. McIntosh Yellin-NL, Drew-BJ, Scheinman-MM. Safety and efficacy ol central intravenous bolus administration of adenosine for termination of supraventricular tachycardia. J Am Coll Cardiol 1993;22:741.

  15. Chronister C. Clinical management of supraventricular tachycardia with adenosine. Am J Crit Care 1993;2:41.

  16. Marco-CA, Cardinale-JF. Adenosine for the treatment of supraventricular tachycardia in the DE. Am J Emerg Med 1994;12:485.

  17. Malcolm AD, Garrat CJ, Camm AJ. The therapeutic and diagnostic cardiac electrophysiological uses of adenosine. Cardiovasc Drugs Ther 1993;7:139.




2020     |     www.medigraphic.com