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【正文】 by DiMarco showed that Adenosine was equally effective to Verapamil with better side effect profile ? Annals of Internal Med 1990。113:104110 Adenosine(cont.) ? Blocks Adenosine receptors causing hyperpolarization of the cell ? Extremely short half life limits side effects ? Maybe ineffective in patients taking methylxanthines ? Has replaced Ca channel blockers that had previously been the first line treatment ? Will break most reentrant SVT’s dependent on the AV node Chronic Treatment ? Dependent on the severity and frequency of symptoms ? Drug Therapy ? Ca Channel blockers, Beta blockers, Dig, Flecainide, Propafenone ? Not entirely effective and side effects ? Catheter Ablation Catheter Ablation ? Has bee the treatment of choice for persistently symptomatic patients ? Those with WPW may be referred for ablation even without persistent symptoms ? Success rates of about 96% have been reported ? About 1% risk of 2nd or 3rd degree AV Block Summary ? Mechanism and Location of SVT has implications for treatment ? EKG holds clues for the type of SVT, although 20% will not be discernable by the EKG ? Adenosine is the mainstay of Acute tx. ? Catheter Ablation is preferred for chronic management
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