Efficacy of adenosine for acute treatment of supraventricular tachycardia in infants and children

This study was done to assess the efficacy and adverse effects of the different doses of adenosine in the pediatric age group with respect to multiple patient variables. Over a period of 1 year, 86 occasions of supraventricular tachycardia [SVT] were treated with adenosine in 81 infants and children aged between 18 days and 12 years [median of 1.3 years, SD=3]. Adenosine efficacy was evaluated in terms of the patients' demographics, SVT rate, electrocardiogram characteristics, and route of drug administration. The dose of 50microg/kg was effective only in 24% of the SVT cases, and the additional doses of 100microg/kg, 150microg/kg, and 200microg/kg were effective in another 29% of the cases. The drug efficacy was higher in the infants than that in the older children. There were no predictors other than age for the estimation of the efficacy of the drug. Our findings showed that the current recommended doses of adenosine are ineffective in the vast majority of children and infants with SVT. No patient-related factor other than age seems to affect the efficacy of the drug