CoChat
Sign Up
Cited by 306Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasAtrial Fibrillation Management and Outcomes

Adenosine for Paroxysmal Supraventricular Tachycardia: Dose Ranging and Comparison with Verapamil: Assessment in Placebo-Controlled, Multicenter Trials

DiMarco, John P., Miles, William, Akhtar, Masood, Milstein, Simon, Sharma, Arjun D., Platia, Edward, McGovern, Brian, Scheinman, Melvin M. +1 more·1990·Annals of Internal Medicine
DOI 10.7326/0003-4819-113-2-104
Open this paper in CoChat — free account

Abstract

OBJECTIVE: To assess the safety and efficacy of intravenous adenosine in terminating acute episodes of paroxysmal supraventricular tachycardia. DESIGN: Two prospective, double-blind, randomized, placebo-controlled trials to evaluate dose response in patients receiving adenosine and to compare the effects of adenosine with those of verapamil. PATIENTS: A total of 359 patients with a tachycardia electrocardiographically consistent with paroxysmal supraventricular tachycardia were entered into the two protocols. Patients subsequently found to have arrhythmias other than paroxysmal supraventricular tachycardia were excluded from the efficacy analysis. INTERVENTIONS: The first protocol compared sequential intravenous bolus doses of 3, 6, 9, and 12 mg of adenosine to equal volumes of saline. In the second protocol, patients received either 6 mg and, if necessary, 12 mg of adenosine or 5 mg and, if necessary, 7.5 mg of verapamil. MEASUREMENTS AND MAIN RESULTS: When data are expressed in terms of cumulative response in eligible patients, intravenous adenosine terminated acute episodes of paroxysmal supraventricular tachycardia in 35.2%, 62.3%, 80.2%, and 91.4% of patients who received maximum doses of 3, 6, 9, and 12 mg, respectively, in a four-dose sequence, whereas 8.9%, 10.7%, 14.3%, and 16.1% of patients responded to four sequential placebo doses (P less than 0.0001). In the second trial, cumulative response rates after 6 mg followed, if necessary, by 12 mg of adenosine were 57.4% and 93.4%, and after 5 mg followed, if necessary, by 7.5 mg of verapamil were 81.3% and 91.4%. The average time after injection to termination of tachycardia by adenosine was 30 seconds. Adenosine caused adverse effects in 36% of patients, but they lasted less than 1 minute and were usually mild. CONCLUSIONS: Adenosine in graded doses up to 12 mg rapidly and effectively terminates acute episodes of paroxysmal supraventricular tachycardia in which the atrioventricular node is an integral part of the re-entrant circuit. The overall efficacy of adenosine is similar to that of verapamil, but its onset of action is more rapid. Adverse reactions to adenosine are common but are minor and brief.

Integrity signals

Registry

Crossref · 10.7326/0003-4819-113-2-104

Cites

16 of 16 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
DiMarco, J. P., Miles, W., Akhtar, M., Milstein, S., Sharma, A. D., Platia, E., McGovern, B., Scheinman, M. M., & Govier, W. C.
Affiliations
  • University of Virginia Medical Center (US)
  • The Adenosine for PSVT Study Group
Corresponding author
DiMarco, John P.
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1990-07-15
Volume
113
Issue
2
Pages
104-110
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-113-2-104
OpenAlex
W2086637755
Cited by
306
References
16
Citations by year
2026: 4 · 2025: 9 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 9 · 2014: 6 · 2013: 4 · 2012: 5
FWCI
21.48
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
adenosine, verapamil, intravenous antiarrhythmic therapy, dose-response relationship, tachycardia termination, adverse effects, drug safety and efficacy, calcium channel blockers
MeSH terms
Acute Disease, Adenosine, Adult, Aged, Clinical Protocols, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Injections, Intravenous, Male, Middle Aged, Prospective Studies, Tachycardia, Paroxysmal, Tachycardia, Supraventricular, Verapamil, Multicenter Studies as Topic, Confounding Factors, Epidemiologic, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review