Overview of drug treatment for paroxysmal supraventricular tachycardia in Taiwan emergency departments: Adenosine using trend from 2000 to 2012.

Background: Before 2010, guidelines recommended adenosine 6, 12, and a repeat dose of 12 mg for paroxysmal supraventricular tachycardia (PSVT). After 2010, these doses were reduced to two. This study aims to outline adenosine using trend from 2000 to 2012 in Taiwan emergency departments (EDs).
Methods: This was an ecological study. PSVT were drawn from one million individuals of the National Health Insurance Database. The χ ² test was used to determine an association between different adenosine doses and other antiarrhythmic drugs (OADs), including verapamil, diltiazem, amiodarone, digoxin, and labetalol.
Results: There were 3361 PSVT visits from 2000 to 2012; 834 (24.8%) did not receive an antiarrhythmic drug, and 2527 (75.2%) did, either adenosine with/without OADs or OADs alone. The use of an OAD was significantly different between the adenosine 6-18 mg and 19 + mg groups.
Conclusions: Most PSVT episodes converted with adenosine within 18 mg, and the success conversion rate was 62.2%. It could be up to 65.2% if they received more. Of the patients who did not have their PSVT reverted with< 18 mg, 37.8% could have been successfully treated with more doses. The necessity of using the 3rd dose of adenosine is needed to be further explored.
Competing Interests: Conflict of interest disclosure To the best of our knowledge, the named authors have no conflict of interest, financial or otherwise.
(Copyright © 2021 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)