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 .
Acute conversion of paroxysmal supraventricular tachycardia with intravenous diltiazem. IV Diltiazem Study Group.
Diltiazem has electrophysiologic effects similar to those of verapamil . Its efficacy and safety in 4 doses for treatment of induced supraventricular tachycardia ( SVT ) were examined and compared with those of placebo in 87 patients ( 25 with atrioventricular [ AV ] nodal reentry tachycardia , 60 with AV reentry associated with an accessory AV connection , and 2 with atrial tachycardia ) .  Conversion to sinus rhythm occurred in 4 of 14 patients ( 29 % ) with 0.05 mg/kg of diltiazem , 16 of 19 ( 84 % ) with 0.15 mg/kg , 13 of 13 ( 100 % ) with 0.25 mg/kg , and 14 of 17 ( 82 % ) with 0.45 mg/kg compared with 6 of 24 ( 25 % ) treated with placebo .  Conversion rates in groups receiving doses of 0.15 to 0.45 mg/kg of diltiazem were superior to that in the placebo group ( p less than 0.001 ) . Time to conversion was 3.0 + /- 2.6 minutes in responding diltiazem patients compared with 5.9 + /- 6.1 minutes in responding control patients . Diltiazem administration result ed in significant lengthening of SVT cycle length , AH interval , and AV nodal effective refractory period and block cycle length . The most frequent adverse response to diltiazem was hypotension ( 7 of 63 patients ) ; however , only 4 patients had symptoms related to hypotension . Thus , intravenous diltiazem in doses of 0.15 , 0.25 and 0.45 mg/kg is an effective and safe treatment for the acute management of SVT
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 .