In the pooled analysis there was no significant difference in reversion rate or relapse rate between the two drugs .
Adenosine and verapamil are both effective treatments for supraventricular tachycardia in the majority of patients .
BACKGROUND Patients with paroxysmal supraventricular tachycardia frequently present to the Emergency Department .
Where vagal manoeuvres fail , the two most commonly used drugs are adenosine and calcium channel antagonists .
Both are known to be effective but both have a significant side-effect profile .
OBJECTIVES To examine the relative effects of adenosine and calcium channel antagonists and , if possible , to determine which is most appropriate for the management of supraventricular tachycardia .
Randomized controlled trial of midazolam premedication to reduce the subjective adverse effects of adenosine.
OBJECTIVE To determine the safety and efficacy of midazolam premedication to minimize the subjective adverse effects of adenosine . METHODS Double-blind prospect i ve r and omized controlled trial of patients presenting to an urban emergency department . Included were a convenience sample of patients who would have received adenosine by the existing department protocol . Exclusion criteria were pregnancy , benzodiazepine allergy , regular benzodiazepine medication , alcoholism , altered mental state ( precluding informed consent ) , and age less than 18 or greater than 65 years . Subjects received either 1.5 mg of intravenous midazolam or normal saline placebo 5 min prior to the administration of adenosine . Side-effect recall was judged by a question naire at 1 h and 24 h postadenosine administration . RESULTS A total of 34 patients were recruited into the trial , 16 in the placebo group and 18 in the midazolam group . The groups were well matched for demographics , treatment and outcome . There was a significant reduction in the midazolam group for complaint scores of palpitations ( P = 0.04 ) and chest pain ( P = 0.02 ) and a trend to reduction in complaint scores for most other parameters . There were no adverse outcomes in any of the patients studied . CONCLUSIONS Co-administration of midazolam can safely reduce the recall of the unpleasant adverse effects of adenosine . Its use may be most appropriate in patients who are particularly anxious or have had previous adverse experiences with adenosine
In the pooled analysis there was no significant difference in reversion rate or relapse rate between the two drugs .
Adenosine and verapamil are both effective treatments for supraventricular tachycardia in the majority of patients .
BACKGROUND Patients with paroxysmal supraventricular tachycardia frequently present to the Emergency Department .
Where vagal manoeuvres fail , the two most commonly used drugs are adenosine and calcium channel antagonists .
Both are known to be effective but both have a significant side-effect profile .
OBJECTIVES To examine the relative effects of adenosine and calcium channel antagonists and , if possible , to determine which is most appropriate for the management of supraventricular tachycardia .