Literature DB >> 26309644

To decide medical therapy according to ECG criteria in patients with supraventricular tachycardia in emergency department: adenosine or diltiazem.

Halil Dogan1, Dogac Niyazi Ozucelik2, Kurtulus Aciksari3, Ilker Murat Caglar4, Nursel Okutan1, Mustafa Yazicioglu1, Baris Murat Avyaci1, Cem Simsek1, Derya Ozasir1, Tufan Akin Giray1, Cem Ayan1, Feridun Celikmen5, Yıldız Okuturlar6, Sezgin Sarikaya5.   

Abstract

UNLABELLED: The aim of this study is to investigate the effect of ECG criteria which are used for the distinction between AVNRT and AVRT for the choice of treatment in patients with Supraventricular Tachycardia (SVT). The 77 patients with narrow QRS complex SVT which was treated with Adenosine or Diltiazem in the Emergency Department were evaluated retrospectively. All 12-lead ECG during tachycardia were blindly reviewed according to ECG criteria (Pseudo-r` in V1, Pseudo-S-wave in the inferior leads, Visible P-wave, aVL notch) by a cardiologist and an emergency physician. In this study, while 59.6% of the patients returned to normal sinus rhythm (NSR) after the first dose 6 mg, 64.91% of them after the first dose 12 mg and 71.92% of them after the second dose of 12 mg adenosine, 95% of the patients returned to NSR after the 0.25 mg/kg diltiazem. The most visible ECG findings were visible P waves and the least visible ECG findings were Pseudo-S waves in the inferior leads. It was statistically significant between converted by adenosine to NSR and converted by diltiazem to NSR to the presence of visible P-wave and the aVL lead notch in their ECG findings.
CONCLUSION: The rate of return to NSR through diltiazem was found higher than that of adenosine in narrow complex SVT patients. Also, diltiazem may be the first medication to be preferred in the presence of retrograt P wave and aVL notch in the ECG of the patients with narrow QRS complex stable SVT.

Entities:  

Keywords:  AVNRT; AVRT; SVT; adenosine; diltiazem; emergency medicine; supraventricular tachycardia

Year:  2015        PMID: 26309644      PMCID: PMC4537958     

Source DB:  PubMed          Journal:  Int J Clin Exp Med        ISSN: 1940-5901


  21 in total

1.  Electrocardiographic differentiation of common type atrioventricular nodal reentrant tachycardia from atrioventricular reciprocating tachycardia via a concealed accessory pathway.

Authors:  Konstantinos P Letsas; Reinhold Weber; Claudia Herrera Siklody; Constantinos C Mihas; Jochem Stockinger; Thomas Blum; Dietrich Kalusche; Thomas Arentz
Journal:  Acta Cardiol       Date:  2010-04       Impact factor: 1.718

Review 2.  Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Authors:  Robert W Neumar; Charles W Otto; Mark S Link; Steven L Kronick; Michael Shuster; Clifton W Callaway; Peter J Kudenchuk; Joseph P Ornato; Bryan McNally; Scott M Silvers; Rod S Passman; Roger D White; Erik P Hess; Wanchun Tang; Daniel Davis; Elizabeth Sinz; Laurie J Morrison
Journal:  Circulation       Date:  2010-11-02       Impact factor: 29.690

Review 3.  Classification and differential diagnosis of atrioventricular nodal re-entrant tachycardia.

Authors:  Demosthenes G Katritsis; A John Camm
Journal:  Europace       Date:  2006-01       Impact factor: 5.214

4.  A new electrocardiographic algorithm using retrograde P waves for differentiating atrioventricular node reentrant tachycardia from atrioventricular reciprocating tachycardia mediated by concealed accessory pathway.

Authors:  C T Tai; S A Chen; C E Chiang; S H Lee; Z C Wen; C W Chiou; K C Ueng; Y J Chen; W C Yu; M S Chang
Journal:  J Am Coll Cardiol       Date:  1997-02       Impact factor: 24.094

Review 5.  Diagnosis and management of supraventricular tachycardia.

Authors:  Zachary I Whinnett; S M Afzal Sohaib; D Wyn Davies
Journal:  BMJ       Date:  2012-12-11

6.  Slow-infusion of calcium channel blockers in the emergency management of supraventricular tachycardia.

Authors:  S H Lim; V Anantharaman; W S Teo
Journal:  Resuscitation       Date:  2002-02       Impact factor: 5.262

7.  Paroxysmal supraventricular tachycardia in the general population.

Authors:  L A Orejarena; H Vidaillet; F DeStefano; D L Nordstrom; R A Vierkant; P N Smith; J J Hayes
Journal:  J Am Coll Cardiol       Date:  1998-01       Impact factor: 24.094

8.  Adenosine in the treatment of supraventricular tachycardia: 5 years of experience (2002-2006).

Authors:  Alessandro Riccardi; Eleonora Arboscello; Maria Ghinatti; Pierangela Minuto; Roberto Lerza
Journal:  Am J Emerg Med       Date:  2008-10       Impact factor: 2.469

9.  Slow infusion of calcium channel blockers compared with intravenous adenosine in the emergency treatment of supraventricular tachycardia.

Authors:  S H Lim; V Anantharaman; W S Teo; Y H Chan
Journal:  Resuscitation       Date:  2009-03-03       Impact factor: 5.262

Review 10.  Atrioventricular nodal reentrant tachycardia: a review.

Authors:  L Elvas; S Gursoy; J Brugada; E Andries; P Brugada
Journal:  Can J Cardiol       Date:  1994-04       Impact factor: 5.223

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  2 in total

1.  Clinical Experience with Diltiazem in the Treatment of Cardiovascular Diseases.

Authors:  Luis Rodríguez Padial; Gonzalo Barón-Esquivias; Antonio Hernández Madrid; Domingo Marzal Martín; Vicente Pallarés-Carratalá; Alejandro de la Sierra
Journal:  Cardiol Ther       Date:  2016-03-25

Review 2.  In The Line of Treatment: A Systematic Review of Paroxysmal Supraventricular Tachycardia.

Authors:  Farrukh Ahmad; Majdi Abu Sneineh; Ravi S Patel; Sai Rohit Reddy; Adiona Llukmani; Ayat Hashim; Dana R Haddad; Domonick K Gordon
Journal:  Cureus       Date:  2021-06-07
  2 in total

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