A COMPARATIVE STUDY TO KNOW THE EFFICACY OF VERAPAMIL VERSUS ADENOSINE FOR THE SUPRAVENTRICULAR TACHYCARDIA TREATMENT

Objective: To compare the relative effects of intravenous adenosine with verapamil in emergency treatment of supraventricular tachycardia (SVT) and to conclude which one is best suited for the treatment of SVT. Study Design: A prospective comparative study. Place and Duration: In the Cardiology Unit, Peoples Medical College and Hospital Nawabshah for one year duration from May 2018 to May 2019. Methods: In 90 patients of SVT, adenosine was given and also in 90 subject’s verapamil was given and comparison was recorded. In the adenosine group, the first bolus of 6 mg was administered for cardiovert and an additional 12 mg of bolus was given if cardioversion was not observed within 2 minutes into sinus rhythm. If SVT continued, that case was transferred to the group receiving Verapamil. On the further, intravenous 5mg verapamil was given in the verapamil group for 2 minutes in the bolus, and if SVT persisted, 5 additional mg was again given after ten mints of the first dose. In the case of cardiovascular insufficiency with verapamil, patients were included in the group of adenosine. The blood pressure and heart rate were continuously monitored while drug infusion and 30 minutes after conversion. Results: 180 total cases of spontaneous SVT in stable state were analysed. 54 (60%) cases of the adenosine group were changed to sinus rhythm after 6 mg bolus and with additional 12 mg adenosine bolus 17 (18.89%) patients maintained sinus rhythm. 78.9% was the total efficacy of adenosine. The sinus rhythm was maintained in 74 (82.22%) patients of verapamil group with 5 mg dose, and with 5 mg additional verapamil, sinus rhythm was maintained by 8 (8.89%) patients. 91.1% was the total efficacy of verapamil. A correlation test was performed and there was significant variation in the verapamil efficacy paralleled to adenosine (p = 0.02). Conclusion: This analysis demonstrates the verapamil efficacy over adenosine in order to transform spontaneous SVT into sinus rhythm. Thus, alternative of adenosine is verapamil in the immediate management of SVT. It is safe and profitable for health systems where adenosine is limited. Key words: Adenosine, Supraventricular tachycardia (SVT), efficacy, verapamil