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 .
Electrophysiological mechanisms and determinants of vagal maneuvers for termination of paroxysmal supraventricular tachycardia.
BACKGROUND The vagal maneuvers used for termination of paroxysmal supraventricular reentrant tachycardia ( PSVT ) appear to involve more complex mechanisms than we have known , and further study should be done to explore the possible mechanisms . METHODS AND RESULTS In this study , 133 patients with PSVT and 30 age- and sex-matched control subjects were included . We assessed the effects of different vagal maneuvers on termination of PSVT and compared baroreflex sensitivity and beta-adrenergic sensitivity between the patients with PSVT and control subjects . Out of 85 patients with atrioventricular reciprocating tachycardia ( AVRT ) , vagal maneuvers terminated in 45 ( 53 % ) . Of these , 28 ( 33 % ) terminated in the ante grade limb and 17 ( 20 % ) terminated in the retro grade limb . Out of 48 patients with atrioventricular nodal reentrant tachycardia ( AVNRT ) , vagal maneuvers terminated the tachycardia in the ante grade slow pathway ( 14 % ) or in the retro grade fast pathway ( 19 % ) . Baroreflex sensitivity was poorer but isoproterenol sensitivity test better in patients with AVNRT . Poorer ante grade atrioventricular node conduction properties and better vagal response determined successful ante grade termination of AVRT by vagal maneuvers . Poorer retro grade accessory pathway conduction property but better vagal response determined successful retro grade termination of AVRT . Better sympathetic and vagal response associated with poorer retro grade atrioventricular node conduction determined retro grade termination of AVNRT by the Valsalva maneuver . CONCLUSIONS Both the vagal response and conduction properties of the reentrant circuit determine the tachycardia termination by vagal maneuvers . Improved underst and ing of the interaction of autonomic and electrophysiological mechanisms in maintaining or terminating PSVT may provide important insight into the pathophysiology of these two tachycardias
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 .