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Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia
Congenital Heart Disease,  Clinical Article

Chrysostomou 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.

Methods
  • Retrospective case series.
  • Quaternary University Children's Hospital, Cardiac Intensive Care Unit.
  • Patients who received dexmedetomidine for SVT in the past 5 years.
  • None.
  • 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).

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