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Review
. 2021 Jun 7;13(6):e15502.
doi: 10.7759/cureus.15502. eCollection 2021 Jun.

In The Line of Treatment: A Systematic Review of Paroxysmal Supraventricular Tachycardia

Farrukh Ahmad  1   2 , Majdi Abu Sneineh  3 , Ravi S Patel  3 , Sai Rohit Reddy  3 , Adiona Llukmani  4 , Ayat Hashim  5 , Dana R Haddad  6 , Domonick K Gordon  3
Affiliations
Review

In The Line of Treatment: A Systematic Review of Paroxysmal Supraventricular Tachycardia

Farrukh Ahmad et al. Cureus. .

Abstract

Paroxysmal supraventricular tachycardia (PSVT) is a common tachyarrhythmia, and an electrocardiogram is the best tool for making a diagnosis. If Valsalva maneuvers and carotid sinus massage do not give positive results, then the next choice is either adenosine or calcium channel blockers. At this time, adenosine is the drug of choice of treatment. Verapamil and diltiazem are the most commonly used calcium channel blockers (CCBs). This review aimed to compare the efficacy of both drugs in the treatment of PSVT. We utilized the databases PubMed Central and Medline by using keywords: "calcium channel blockers OR adenosine AND supraventricular tachycardia." In the end, we finalized 32 studies, including observational studies, literature reviews, systematic reviews/metanalysis, and randomized control trials. We included articles only in the English language and related to humans. Two authors completed the quality assessment and evaluation of bias according to specific guidelines. Only high-quality studies were included in this systematic review based on the cut-off score of seven or above. Calcium channel blockers have a longer half-life than adenosine and were previously used as the drug of choice in the treatment of PSVT. Calcium channel blockers are safe if given slowly; however, adenosine is safer and useful when an electrocardiogram is uncertain. We compared both drugs in certain aspects and found equal efficacy. Though safer, adenosine was found to have a higher cost and a higher probability of re-initiation arrhythmia compared to calcium channel blockers.

Keywords: adenosine; calcium channel blockers; supraventricular tachycardia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Treatment Options for Paroxysmal Supraventricular Tachycardia
PSVT= paroxysmal supraventricular tachycardia, CCBs= calcium channel blockers, CSM= carotid sinus massage
Figure 2
Figure 2. Search Strategy PRISMA Flow Diagram
PRISMA= Preferred Reporting Items for Systematic Reviews and Meta-Analyses
See this image and copyright information in PMC

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