Adenosine in the management of supraventricular tachycardia in children

Abstract

Objective: To assess the efficacy and safety of adenosine in the management of supraventricular tachycardia in children.

Methodology: A review of 43 children with supraventricular tachycardia who received intravenous adenosine between June 1992 and July 1995.

Results: Thirty-five patients had re-entrant supraventricular tachycardia and eight patients had atrial tachydysrhythmias. Reversion to sinus rhythm occurred in 75% of episodes in all patients treated for supraventricular tachycardia, and in 96% of episodes in patients with re-entrant supraventricular tachycardia. Early re-initiation of supraventricular tachycardia after reversion to sinus rhythm occurred in 25% of episodes. Sixteen percent of patients reverted with the recommended 0.05 mg/kg starting dose, and 35% reverted with a dose of 0.1 mg/kg. Four patients were given adenosine as a diagnostic procedure to elicit occult pre-excitation. The most common side effects were brief feelings of discomfort. No serious side effects occurred.

Conclusion: Adenosine is safe and effective in the management of supraventricular tachycardia in children. A commencing dose of 0.1 mg/kg is appropriate.