Adenosine for Regular Wide-Complex Tachycardia

Adenosine is safe and effective for differentiating wide-complex supraventricular tachycardia from ventricular tachycardia.

Distinguishing ventricular tachycardia (VT) from supraventricular tachycardia (SVT) with aberrancy (preexisting bundle branch block or rate-related aberration in intraventricular conduction) is a dilemma in the management of regular wide-complex tachycardia. Historically, some clinicians have been reluctant to use adenosine in this setting, because of fear of degeneration of VT to fibrillation or promotion of rapid conduction through an accessory tract. To assess the safety and efficacy of adenosine in regular wide-complex tachycardia of unknown etiology, these authors reviewed patient records at nine U.S. medical centers from 1991 to 2006.

Case ascertainment criteria varied among centers. The main outcome was response to adenosine (slowing …

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education