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Point | Counterpoint – Adenosine First-Line for SVT?

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Adenosine is an effective, rapid onset, short acting atrioventricular (AV) nodal blocker that can be used as a diagnostic aid for regular narrow and wide complex tachycardias and for definitive management for supraventricular tachycardia (SVT). It should remain first-line over calcium channel blockers (CCB) for SVT.


Make new friends, but keep the old. CCBs are silver, but adenosine is gold!

Patients with stable SVT should be initially managed with vagal maneuvers, but what if that fails?  This clinical controversy article discusses the advantages of adenosine for treatment of SVT over other AV nodal blocking agents, such as CCBs and beta blockers (BB).


Adenosine’s rapid onset and short half-life (~10 seconds) make it a superb option for SVT and diagnostic tool to establish the underlying rhythm in both wide and narrow complex regular tachyarrhythmias (AVNRT, AVRT, Atrial Flutter, SVT with aberrancy, VTach, etc.).


Source

Adenosine Should be First-Line Treatment for Supraventricular Tachycardia. Annals of Emergency Medicine. Published December 19, 2023. doi: 10.1016/j.annemergmed.2023.10.017

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