Evidence-based evaluation of the efficacy and safety of adenosine injection in paroxysmal supraventricular tachycardia
Objective To evaluate the efficacy and safety of adenosine injection for cardioversion of paroxysmal supraventricular tachycardia(PSVT).Methods We conducted a computer-based search in PubMed,Embase,the Cochrane Library,CNKI,Wanfang database,and the Chinese Biomedical Literature database to collect RCT and single-arm trial(SAT)published in the core journals of Chinese science and technology papers from the establishment of the databases to January 2024.These trials evaluated the use of adenosine injection in the conversion of PSVT,and RCTs and SATs were analyzed separately using RevMan 5.4 and Stata 15.1 software for meta-analysis.For the English databases,no journal restrictions were applied.Results A total of 26 studies were included,comprising 8 RCTs and 18 SATs.In terms of conversion success rate,adenosine injection doses ranged were slightly higher than those of other positive drugs,and the success rate was dose-related.The overall conversion success rate of adenosine injection in terminating PSVT was 0.91(95%CI:0.86 to 0.95).Among these patients,34%patients effectively terminated PSVT at the dosage of 3 mg,60%at the dosage of 6 mg,49%at the dosage of 9 mg,23%at the dosage of 12 mg,4%at the dosage of 15 mg,and 9%at the dosage ranged from 18 mg to 30 mg.In terms of conversion success time,adenosine had a significant advantage compared to other non-adenosine-positive drugs,and the difference was statistically significant(P<0.05).Regarding safety,the incidence of adverse reactions in the adenosine group was slightly lower than that in other positive drug groups,but the difference was not statistically significant(RR=0.80,95%CI:0.62 to 1.03,P>0.05).Conclusion Adenosine injection is an effective treatment for the treatment of PSVT,and the effectiveness of adenosine at the dosage of 6 mg in terminating PSVT is significantly improved.The recommended dosage of adenosine typically ranges from 6 mg to 12 mg with good safety.
万方数据
维普
