World Journal of
Pharmaceutical and Life Sciences

COMPARISON BETWEEN ADENOSINE AND VERAPAMIL IN TREATMENT OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA AMONG IRAQI PATIENTS IN AL-YARMOUK TEACHING HOSPITAL

Riyam Adnan Alwan* and Abbas Naji Al-Sharifi

ABSTRACT

Background: Paroxysmal supraventricular tachycardia is a clinical syndrome of rapid regular tachycardia with an
abrupt onset and termination. Acute management includes controlling the rate and preventing hemodynamic
collapse. Adenosine has been classified as a miscellaneous antiarrhythmic drug outside the Vaughan- Williams
classification scheme. Verapamil has a longer half-life than adenosine and may help to maintain sinus rhythm
following the termination of supraventricular tachycardia. Aim of study: To detect the difference in response to
treatment of patients with paroxysmal supraventricular tachycardia to either adenosine or verapamil for reaching to
sinus rhythm. Methods: A comparative clinical trial study that conducted in the Emergency Department for a
period of six months from 15th of Feb. till 15th of Aug. 2021. It included 60 adult patients who were admitted to the
emergency department with paroxysmal supraventricular tachycardia and whose condition failed to respond to
vagal maneuvers. They were divided into two groups: Adenosine group included 30 adult patients received
adenosine shoots and verapamil group included 30 adult patients received verapamil ampule shoots. Follow up
continued for six hrs. for all patients in the emergency department under continuous cardiac monitoring. If the
rhythm on the monitor changed, an ECG was taken immediately and if the new ECG showed the recurrence of
paroxysmal supraventricular tachycardia, the patient was treated accordingly. Measurement of blood pressure was
done every 5– 10 mints. Baseline vital signs and ECG findings were recorded before intervention and then 30 and
120 mints. after rhythm control. Results: In this study, the time required for conversion of paroxysmal
supraventricular tachycardia to sinus rhythm was significantly shorter in adenosine group than that in verapamil
group. There was no treatment failure among certain group that necessitated the administration of the other group
item. Conclusion: Adenosine was superior to verapamil in the management of supraventricular tachycardia as it
has rapid onset of action. Verapamil still good option for the treatment of supraventricular tachycardia where
adenosine is not available.

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