title: The value of adrenaline in the induction of supraventricular tachycardia in the electrophysiological laboratory.
abstract: OBJECTIVE
  The most commonly used drug for the facilitation of supraventricular tachycardia (SVT) induction in the electrophysiological (EP) laboratory is isoprenaline. Despite isoprenaline's apparent indispensability, availability has been problematic in some European countries. Alternative sympatomimethic drugs such as adrenaline have therefore been tried. However, no studies have determined the sensitivity and specificity of adrenaline for the induction of SVT. The objective of this study was to determine the sensitivity and specificity of adrenaline for the induction of SVT.
  
  
  RESULTS
  Between February 2010 and July 2013, 336 patients underwent an EP study for prior documented SVT. In 66 patients, adrenaline was infused because tachycardia was not induced under basal conditions. This group was compared with 30 control subjects with no history of SVT. Programmed atrial stimulation was carried out during baseline state and repeated after an infusion of adrenaline (dose ranging from 0.05 mcg/kgc to 0.3 mcg/kgc). The endpoint was the induction of SVT. Among 66 patients with a history of SVT but no induction under basal conditions, adrenaline facilitated induction in 54 patients (82%, P < 0.001). Among the 30 control subjects, SVT was not induced in any patient (0%) after infusion. Adrenaline was generally well tolerated, except for two patients (3.0%), where it had to be discontinued due to headache and high blood pressure or lumbar pain.
  
  
  CONCLUSIONS
  Adrenaline infusion has a high sensitivity (82%) and specificity (100%) for the induction of SVT in patients with prior documented SVT. Therefore, it could serve as an acceptable alternative to isoprenaline, when the latter is not available.
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cismaru
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Rosu
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Lucian
authors.initials: L
authors.lastname: Muresan
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Puiu
authors.affiliation: CHU de Nancy, Department of Cardiology, University Hospital Nancy, 54511 Nancy, France.
authors.forename: Marius
authors.initials: M
authors.lastname: Andronache
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Erika
authors.initials: E
authors.lastname: Hengan
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ispas
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gusetu
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania Spitalul Clinic de Recuperare, Sectia Cardiologie, Strada Viilor 46-50, 400347 Cluj-Napoca, Romania pop7dana@yahoo.com.
authors.forename: Dana
authors.initials: D
authors.lastname: Pop
authors.affiliation: 1st Department of Internal Medicine-Gastroenterology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Petru Adrian
authors.initials: PA
authors.lastname: Mircea
authors.affiliation: Department of Cardiology-Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
authors.forename: Dumitru
authors.initials: D
authors.lastname: Zdrenghea
mesh_terms: D000200:Action Potentials; D000322:Adrenergic Agonists / Q000008:administration & dosage / Q000009:adverse effects; D016022:Case-Control Studies; D022062:Electrophysiologic Techniques, Cardiac; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D000322:Adrenergic Agonists; D004837:Epinephrine
keywords: Adrenaline; Electrophysiological study; Isoprenaline; Supraventricular tachycardia