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Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia.

Publication ,  Journal Article
Chrysostomou, C; Morell, VO; Wearden, P; Sanchez-de-Toledo, J; Jooste, EH; Beerman, L
Published in: Congenit Heart Dis
2013

OBJECTIVES: The current drug of choice for reentrant supraventricular tachycardia (SVT) is adenosine followed by verapamil or diltiazem. Although limitations and significant adverse events have been encountered over the years, an alternative effective and safe agent has not been available. Dexmedetomidine has recently been shown to have potential antiarrhythmic effects, and here we describe our experience in the acute termination of reentrant SVT. DESIGN: Retrospective case series. SETTING: Quaternary University Children's Hospital, Cardiac Intensive Care Unit. PATIENTS: Patients who received dexmedetomidine for SVT in the past 5 years. INTERVENTIONS: None. OUTCOME MEASURES: SVT episodes terminated with dexmedetomidine were compared with episodes terminated with adenosine. RESULTS: Fifteen patients, median age of 10 days (6-16), were given 27 doses of dexmedetomidine, mean dose 0.7 ± 0.3 mcg/kg, for a total of 27 episodes of SVT. Successful termination occurred in 26 episodes (96%) at a median time of 30 seconds (20-35). Duration of sinus pause was 0.6 ± 0.2 seconds, there was one episode of hypotension and no bradycardia and sedation lasted for 34 ± 8 minutes. Five patients received 27 doses of adenosine, with an overall successful cardioversion in 17 patients (63%) (P= .0017). Transient bradycardia and hypotension was seen in three patients (11%), agitation in 16 patients (59%), and broncospasm in one patient. Median sinus pause was 2.5 seconds (2-9) (P < .001). CONCLUSIONS: Dexmedetomidine appears to have novel antiarrhythmic properties for the acute termination of reentrant SVT. Although adenosine is very effective, dexmedetomidine may prove to possess a more favorable therapeutic profile with increased effectiveness and fewer side effects.

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Published In

Congenit Heart Dis

DOI

EISSN

1747-0803

Publication Date

2013

Volume

8

Issue

1

Start / End Page

48 / 56

Location

United States

Related Subject Headings

  • Tachycardia, Supraventricular
  • Retrospective Studies
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Defects, Congenital
  • Dexmedetomidine
  • Child, Preschool
  • Cardiovascular System & Hematology
  • Anti-Arrhythmia Agents
 

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Chrysostomou, C., Morell, V. O., Wearden, P., Sanchez-de-Toledo, J., Jooste, E. H., & Beerman, L. (2013). Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia. Congenit Heart Dis, 8(1), 48–56. https://doi.org/10.1111/j.1747-0803.2012.00669.x
Chrysostomou, Constantinos, Victor O. Morell, Peter Wearden, Joan Sanchez-de-Toledo, Edmund H. Jooste, and Lee Beerman. “Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia.Congenit Heart Dis 8, no. 1 (2013): 48–56. https://doi.org/10.1111/j.1747-0803.2012.00669.x.
Chrysostomou C, Morell VO, Wearden P, Sanchez-de-Toledo J, Jooste EH, Beerman L. Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia. Congenit Heart Dis. 2013;8(1):48–56.
Chrysostomou, Constantinos, et al. “Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia.Congenit Heart Dis, vol. 8, no. 1, 2013, pp. 48–56. Pubmed, doi:10.1111/j.1747-0803.2012.00669.x.
Chrysostomou C, Morell VO, Wearden P, Sanchez-de-Toledo J, Jooste EH, Beerman L. Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia. Congenit Heart Dis. 2013;8(1):48–56.
Journal cover image

Published In

Congenit Heart Dis

DOI

EISSN

1747-0803

Publication Date

2013

Volume

8

Issue

1

Start / End Page

48 / 56

Location

United States

Related Subject Headings

  • Tachycardia, Supraventricular
  • Retrospective Studies
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Defects, Congenital
  • Dexmedetomidine
  • Child, Preschool
  • Cardiovascular System & Hematology
  • Anti-Arrhythmia Agents