Comparison of Single-syringe vs. Double-syringe Techniques for Adenosine Administration in PSVT

Hormozgan University of Medical Sciences131 enrolled

Overview

The purpose of the study is to compare the effectiveness of two different methods of administering adenosine for the treatment of stable supraventricular tachycardia (SVT).

The American Heart Association 2015 guidelines recommend adenosine for non-hypotensive patients with regular narrow complex SVT. Adenosine is usually given as a rapid intravenous bolus of 6mg over 1-2 seconds, followed by a 20ml saline flush. If the first dose does not result in the termination of SVT to normal sinus rhythm (NSR) within 1-2 minutes, a repeat dose of 12mg can be given, and the dose may be repeated one more time, if necessary, for a total of three doses. The double-syringe technique (DST) is the standard method for administering adenosine. However, recent studies suggest that the single-syringe technique (SST) may be simpler and potentially beneficial. This technique injects adenosine and saline simultaneously at the same time instead of two separate injections. The study aims to determine if the SST method is non-inferior to the DST method.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

131

Conditions

Supraventricular Tachycardia Supraventricular Tachycardias Supraventricular Arrhythmia SVT PSVT

Interventions

Single-syringe AdenosineDRUG

Simplified method, containing both 6 mg of adenosine and 18 mL NS. If SVT termination failed: Second dose of adenosine with SS containing both 12 mg of adenosine and 18 mL NS. A total of three doses could be provided to each patient

Double Syringe AdenosineDRUG

One Syringe containing 6 mg of adenosine + one syringe containing 20 mL NS aided with a stopcock. If SVT termination failed: Second dose of adenosine (12 mg) + one syringe containing 20 mL NS. A total of three doses could be provided to each

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 18 to 80 years * Presentation to the emergency department with narrow-QRS tachyarrhythmia * Heart rate ≥150 beats/min * No visible P wave or presence of retrograde P wave on ECG * Not responsive to Valsalva maneuvers lasting 15 to 30 seconds * Requiring adenosine administration Exclusion Criteria: * Wide-QRS tachycardia or irregular R-R interval on ECG * Known allergy or contraindication to adenosine * Recent ingestion of dipyridamole, carbamazepine, or theophylline * Caffeine ingestion within the previous 2 hours

Locations (2)

Shahid Mohammadi Hospital

Bandar Abbas, Hormozgan, Iran

Shahid Mohammadi Hospital

Bandar Abbas, Iran

Outcomes

Primary Outcomes

First-dose successful termination of PSVT

Proportion of participants with conversion from paroxysmal supraventricular tachycardia to sinus rhythm after the first dose of adenosine.

Time frame: Within 2 minutes after administration of the first dose of adenosine.

Secondary Outcomes

Total administered dose of adenosine.

Total cumulative dose of adenosine (mg) administered to achieve termination of PSVT.

Time frame: From administration of the first dose until successful termination of PSVT or up to 10 minutes, whichever occurs first.

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.