Delayed adenosine therapy is associated with the refractory supraventricular tachycardia in children
- Authors
- Kim, Jung Heon; Jung, Jae Yun; Lee, Se Uk; Park, Joong Wan; Choi, Jea Yeon
- Issue Date
- Nov-2020
- Publisher
- W.B. Saunders
- Keywords
- Adenosine; Child; Emergency Medicine; Risk Factors; Supraventricular; Tachycardia
- Citation
- American Journal of Emergency Medicine, v.38, no.11, pp.2291 - 2296
- Journal Title
- American Journal of Emergency Medicine
- Volume
- 38
- Number
- 11
- Start Page
- 2291
- End Page
- 2296
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/19453
- DOI
- 10.1016/j.ajem.2019.10.018
- ISSN
- 0735-6757
- Abstract
- Objectives: To study the association of time intervals on adenosine therapy with the occurrence of refractory supraventricular tachycardia (SVT) in children. Methods: We reviewed 334 episodes of presumed SVT requiring adenosine in children (<18 years) who visited 4 academic hospital emergency departments (EDs) from July 2013 through June 2017. Refractory SVT was defined as an SVT episode persisting after 2 doses of adenosine. Clinical and electrocardiographic findings, and symptom-to-adenosine (symptom-to-ED plus ED-to-adenosine) time of refractory and responsive SVT episodes were compared. Multivariable logistic regression was performed to identify factors associated with the occurrence of refractory SVT. Results: Of 211 SVT episodes, 42 episodes of refractory SVT (19.9%) were noted (overall sinus conversion rate, 79.6%). The refractory episodes were associated with a higher frequency of known structural heart diseases (9.5% vs. 1.8%; P = 0.030) and a longer median ED-to-adenosine time (15.5 vs. 11.0 min; P = 0.018). The association of the ED-to-adenosine time with refractory SVT remained significant after adjustment (for increment of 1 min; aOR, 1.02; 95% CI, 1.007–1.04). Conclusions: Delayed adenosine therapy is associated with the occurrence of refractory SVT in children, supporting the need for prompt adenosine therapy. © 2019 Elsevier Inc.
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