Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia
Congenital Heart Disease, 05/31/2012Chrysostomou C et al.
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.
Retrospective case series.
Quaternary University Children's Hospital, Cardiac Intensive Care Unit.
Patients who received dexmedetomidine for SVT in the past 5 years.
SVT episodes terminated with dexmedetomidine were compared with episodes terminated with adenosine
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).
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