The following is a summary of “Effect of patient weight on the success of converting sinus rhythm in patients with PSVT treated with standard dose adenosine,” published in the July 2023 issue of Emergency Medicine by Çorbacioğlu et al.

Patients with supraventricular tachycardia (SVT) were examined to determine if there is a difference in the quantity of adenosine per kilogram (mg/kg) between patient groups that can and cannot be converted to sinus rhythm (SR) with adenosine therapy. This retrospective, single-center study was conducted in the emergency department of a teaching and research hospital between December 1, 2019, and December 1, 2022, on patients diagnosed with SVT and treated with a 6–12–18 mg adenosine protocol. The primary analyses were conducted in three phases. The initial evaluation considered the initial 6 mg dose of adenosine administered. 

The second analysis believed the 12 mg of adenosine administered as the double dose, given that the initial amount had no effect. Finally, a third analysis was conducted by considering the 18 mg of adenosine administered as the third dose, as the subject did not respond to the previously administered doses. The primary outcome variable was SR conversion, and two groups were formed: the successful SR group and the unsuccessful SR group. Seventy-three patients admitted to the ED with a PSVT diagnosis and treated with intravenous adenosine were included in the study. After administering 6 mg of adenosine to all 73 patients, SR was attained in only 38%.

The mean adenosine dose (mg/kg) was significantly lower in the failure SR group, 0.07373±  0.014 than in the success SR group, 0.08885 ± 0.017 mg/kg (mean difference with 95% CI: -0.01511 [-0.023 to -0.0071]; p <0.001). Comparing the administrations with successful and unsuccessful SR in the second and third-stage analyses involving 12 and 18 mg adenosine doses revealed no difference in the administered adenosine doses per kilogram. According to this study, the efficacy of terminating SVT with the initial 6 mg dose of adenosine depends on the patient’s weight. In patients administered larger doses of adenosine, PSVT termination efficacy may be determined by factors other than patient weight.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001754