If you only find 30% revert with adenosine, you are either not giving
the right dosage in the right way, or giving the adenosine to patients
without an SVT. The following is taken from the Prodigy website. A bit
higher than 30% I suspect. Intravenous adenosine is now the drug of
choice for terminating SVT. It has a rapid, short-lived action, blocking
conduction through the atrioventricular (AV) node, and is effective in
virtually all cases of junctional tachycardia.
Intraveous adenosine can also help diagnose an arrhythmia. If a
tachycardia is halted, it is likely to have been junctional in origin.
If there is transient AV block with specific ECG changes (characteristic
P waves, flutter, or fibrillation waves) the arrhythmia is likely to be
atrial tachycardia, flutter, or fibrillation. If adenosine has no effect
the arrhythmia is likely to be ventricular in origin [DTB, 1993; Chun
and Sung, 1995; Ganz and Friedman, 1995; Li-Saw-Hee, 1998].
As a side issue asthma is a contra-indication/or cautioned. Due to its
short half life, it is probably still quite safe?is there much evidence
for catastrophy from using adenosine in asthmatics.
Andy Webster
A&E SPR, and fan of adenosine
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Rowley Cottingham
Sent: 20 October 2003 21:01
To: [log in to unmask]
Subject: Re: SVT
> Can anyone figure why Tony Blair needed a cardioversion i.e. DC shock?
> I've
> only very rarely seen SVT not respond to adenosine, and on those rare
> occasions verapamil always worked.
>
> AF
>
>
Not my experience at all. I only see about 30% revert with adenosine. I
tend to ask for
cardioversion rather than verapamil as the next step.
Best wishes,
Rowley Cottingham
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