DefinePK

Abstract

Background: Supraventricular tachycardia (SVT) is a critical cardiac emergency necessitating medical intervention. The comparative efficacy and safety profiles of adenosine and verapamil in Pakistani population have not been extensively studied. This study aims to compare the efficacy of slow infusion adenosine versus verapamil in the treatment of SVT in Pakistani patients. Methods: A prospective experimental study was conducted involving 100 patients with SVT at a tertiary care hospital in Pakistan. Patients were randomly assigned to receive either a slow infusion of adenosine (n=50, initial dose 6 mg followed by 12 mg if needed) or verapamil (n=50, 1 mg/min up to 20 mg) after the initial Valsalva manoeuvre. The primary outcome was successful termination of SVT. Secondary outcomes included haemodynamic changes and adverse effects. Results: The mean age was comparable between groups (adenosine: 52.02±12.19 years, verapamil: 51.98±13.90 years). Verapamil proved superior efficacy with a 100% conversion rate compared to 90% with adenosine (p=0.02). Both groups showed similar haemodynamic stability, with no significant differences in post-conversion systolic blood pressure, (verapamil: 123.70±22.35 mmHg vs adenosine: 122.14±15.79 mmHg, p=0.68) and diastolic blood pressures. The adenosine group reported higher rates of apprehension (62.9%) and ECG events (63.2%), while both groups showed comparable incidences of other side-effects. Conclusion: Verapamil showed higher conversion success compared to adenosine in treating SVT and maintained a favourable safety profile. Verapamil is an effective alternative to adenosine in the management of SVT.
Pak J Physiol 2025;21(3):26–9, DOI: https://doi.org/10.69656/pjp.v21i3.1835