Heart rate is a predictor of success in the treatment of adults with symptomatic paroxysmal supraventricular tachycardia.

نویسندگان

  • Piercarlo Ballo
  • Daniele Bernabò
  • Sergio Antonio Faraguti
چکیده

AIMS To analyse whether heart rate may affect the efficacy of adenosine, verapamil and carotid sinus massage in terminating symptomatic episodes of paroxysmal supraventricular tachycardia (PSVT) in adults. METHODS AND RESULTS The study population was selected among 175 adult patients, affected by symptomatic PSVT. One hundred and six of them were considered eligible for the study. Each subject received one of the following treatments: verapamil, 5 mg intravenously (IV) in 5-10 min, followed by 1-5 microg/kg/min; adenosine, 6 mg IV, followed by 12 mg IV after 2-3 min; carotid sinus massage. Adenosine and verapamil were similarly effective in terminating PSVT (74.4% vs 81.8%, P=0.45). The efficacy of carotid sinus massage was significantly lower in comparison with the other two groups (32.4%, P=0.00032 vs adenosine and P=0.000044 vs verapamil group). At logistic regression, PSVT rate showed a positive association with the percentage of sinus rhythm restoration in the group who received adenosine (P=0.0004). The probability of success in resolving the tachycardia following treatment with adenosine was > 75% for heart rates over 166 beats per minute (bpm), but rapidly decreased at lower frequencies, reducing to 25% at 138 bpm. In the verapamil group, PSVT rate was negatively related to the percentage of sinus rhythm restoration (P=0.018). The probability of success in terminating PSVT following administration of verapamil was > 75% for heart rates lower than 186 bpm, but tended to decrease at faster rates, reducing to 25% at 241 bpm. No significant effects of heart rate were observed in the carotid sinus massage group (P=0.17). The probability curves obtained in the adenosine and verapamil group crossed at a point corresponding to 173 bpm, which may represent a cut-off value to predict which treatment could ensure higher rate of success. CONCLUSIONS Heart rate predicts restoration of sinus rhythm in adult subjects with symptomatic episodes of PSVT treated with adenosine and verapamil. Adenosine is highly effective in PSVT characterised by fast rates, whereas the efficacy of verapamil is increased in patients with low-frequency PSVT.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Spontaneous occurrence of symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia in untreated patients.

BACKGROUND Ambulatory outpatients (n = 150) with a history of paroxysmal supraventricular arrhythmia were studied to establish the characteristics of the first recurrence of symptomatic tachycardia (time to first recurrence, heart rate during tachycardia, and observed rhythm that was regular versus irregular) when no antiarrhythmic drug was being taken. Baseline variables were examined to asses...

متن کامل

Incidence of symptomatic atrial fibrillation in patients with paroxysmal supraventricular tachycardia.

OBJECTIVES This study was performed to determine the incidence of symptomatic, sustained atrial fibrillation in a group of patients with paroxysmal supraventricular tachycardia. The effects of the mechanism of paroxysmal supraventricular tachycardia (atrioventricular [AV] node reentry vs. AV reentry through an accessory pathway) and heart rate during the tachycardia on the occurrence of atrial ...

متن کامل

A Case Report of Neonatal Atrial Flutter with Poor Feeding and Tachypnea

Background: Arrhythmias in neonates are not common and usually affect newborns with a normal heart or those that suffer from structural heart disease. A malignant type of arrhythmias is supraventricular tachycardia. Meanwhile, one uncommon type of supraventricular arrhythmias is atrial flutter (AFL), which is founded upon reentry mechanisms in the atrium. The AFL may result in heart failure or ...

متن کامل

Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease

An 11-month-old male infant was admitted to our hospital with fever, fussiness, poor feeding, vomiting, and tachypnea for two days prior. Physical examination revealed sporadic papules and vesicles occurring on his hands, feet, face, and perianal mucosa. Enterovirus 71 was identified from both throat swab and vesicle fluid using virus isolation techniques. The patient's heart rate fluctuated in...

متن کامل

Plant lipids that lower serum cholesterol.

1997; 47: 285–9. [17] Cameron A, Schwartz MJ, Kronmal RA et al. Prevalence and significance of atrial fibrillation in coronary artery disease (CASS Registry). Am J Cardiol 1988; 61: 714. [18] Page RL, Wilkinson WE, Clair WK, MaCarthy EA, Pritchett EC. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 199...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • European heart journal

دوره 25 15  شماره 

صفحات  -

تاریخ انتشار 2004