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

The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.

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., Govier, William C.·1990·Annals of Internal Medicine
DOI 10.7326/0003-4819-113-2-104
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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.

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

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Research works printed but not linked: 2

  1. DiMarco J, Cardiac Electrophysiology and Pharmacology of Adenosine and ATP: Basic and Clinical Aspects., 1987, 271
  2. Sellers T, Cardiac Electrophysiology and Pharmacology of Adenosine and ATP: Basic and Clinical Aspects., 1987, 283

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Metadata

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

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