A prognostic index for the successful use of adenosine in patients with paroxysmal supraventricular tachycardia in emergency settings: a retrospective study.
OBJECTIVE
The use of adenosine on failure of vagal maneuvers in patients with paroxysmal supraventricular tachycardia (PSVT) is recommended. The aim of the present study was to identify a possible prognostic index for the efficacy of adenosine in PSVT.


METHODS
This retrospective study included 321 patients with PSVT, in whom vagal maneuvers failed to restore normal sinus rhythm and who received 6 mg adenosine, followed by 12 mg adenosine (repeated if necessary). A 2-step clustering algorithm was used to reveal nonapparent groupings. Various patients' characteristics were inserted into the model.


RESULTS
A straightforward index has been chosen that would aid the distinction of patients failing to respond to adenosine. The formula, (age / heart rate at admission) + number of past PSVT episodes, was chosen as the one that combined the highest sensitivity (96.2%) and specificity (71.2%).


CONCLUSIONS
This prognostic index constitutes a useful and reliable bedside diagnostic tool to identify patients with PSVT who were less likely to respond to adenosine administration in the emergency setting.
Xanthos
Theodoros
T
Department of Experimental Surgery and Surgical Research N.S. Christeas, Athens School of Medicine, 15127 Athens, Greece.
Ekmektzoglou
Konstantinos A
KA
Vlachos
Ioannis S
IS
Dimitroulis
Dimitrios
D
Tsitsilonis
Serafim
S
Karatzas
Theodore
T
Perrea
Despina N
DN
D000241:Adenosine / Q000627:therapeutic use*; D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013617:Tachycardia, Supraventricular / Q000188:drug therapy*; D016896:Treatment Outcome; D014636:Valsalva Maneuver
D000889:Anti-Arrhythmia Agents; D000241:Adenosine