Effectiveness of Adenosine for Patients with Supraventricular Tachycardia in

Emergencies: A Systematic Review

Moh. Ubaidillah Faqih1, Mila Nur Fadlilah2
Master of Nursing, Medical Faculty of Brawijaya University1,
Bachelor of Nursing, STIKES NU Tuban2
First author1, Second author2
Phone number : 085606146981
Email address : moh.ubaidillah.faqih@gmail.com
Background: Supraventricular tachycardia (SVT) is a very serious heart disease and
common rhythm disorder that often requires treatment out of hospital. It can be treated with
drugs, vagal maneuvers, or synchronized electrical cardioversion (SEC). Over the past 20
years, verapamil has become the drug of choice for the treatment of SVT in the pre hospital
setting. However, some studies have shown that adenosine could be as effective as
verapamil, with fewer side effects.
Aims: This systematic review aimed to identify the activity of adenosine in patients
with SVT.
Method: This systematic review used 2 keywords in the search of the existing
literature, namely adenosine and supraventricular tachycardia. This systematic review is only
used literature obtained from sciencedirect and limit time period used between 1990 until
2015. Initial literature search identified 144,509 from adenosine and 14,329 journal articles
from supraventricular tachycardia. Based on all the journal articles obtained from
sciencedirect, only 9 articles that discuss about effectiveness adenosine for SVT in
emergencies included in the review. That articles and appropriate content to the topic
synthesized to obtain the appropriate literature review.
Results: The review found that the first dose of adenosine was effectively
administered once the measures of vagal Maneuvers do not respond. The dosage was
Adenosine 6 mg rapid IV bolus followed by flushing with 20 mL of normal saline. If within 1-2
minutes the rhythm does not change, then given a second dose of 12 mg Adenosine IV
bolus quickly then in flush with 20 ml of normal saline. If there was no improvement, it can be
given back Adenosine 12 mg IV bolus quickly and in flush with 20 ml of normal saline
(maximum dose of 30 mg adenosine). Then continuous ECG monitor for changes
(prognosis) of patients ECG results. The majority articles determined adenosine as an
effective agent for the management of patients with supraventricular tachycardia,
demonstrate a high level cardioversion and has low side effects.
Conclusion: Administration of adenosine is recommended and highly effective for
patients with SVT outside the hospital if given during the pre-hospital and given 6 mg as an
initial dose and 12 mg as a further dose.
Keywords: supraventricular tachycardia, adenosine, the effectiveness