SVT: paroxysmal: adenosine was more effective when given through a central venous line.

Clinical bottom line (level 1b)

  1. Patients with supraventricular tachycardia who received adenosine via a central vein compared with a peripheral vein were more likely to revert to sinus rhythm on 3 mg (NNT = 3 at 10 minutes) .
McIntosh-Yellin et al: Journal of the American College of Cardiology 1993; 22 (3): 741-745
Expires November 2004

The study

Unblinded ?concealed randomised cross-over trial without intention-to-treat
Setting: university hospital, USA

34 patients (aged ?, ?% male) undergoing electrophysiologic investigation who had supraventricular tachycardia (either spontaneous or initiated)

Excluded if
  • aged < 18
  • pregnant
  • allergic or sensitive to adenosine


    • Control Group: (n = 34, 30 analysed): adenosine 3, then 6, 9, 12 mg through a peripheral vein until SVT termination
    Experimental Group: (n = 34, 30 analysed): adenosine 3, then 6, 9, 12 mg through a central vein until SVT termination

    88% followed for 10 minutes

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    SVT not terminated using 3 mg adenosine 10 minutes 19
    (63.3%)    		 7
    (23.3%)    		 63%
    (26% to 82%)    		 40.0%
    (17.1% to 62.9%)    		 3
    (2 to 6)

  • All patients' SVT were successfully terminated

    • Citation

    1. McIntosh-Yellin NL, Drew BJ, Heinman : Efficacy of central intravenous bolus administration of adenosine for termination of supraventricular tachycardia. Journal of the American College of Cardiology 1993; 22 (3): 741-745
    Contributor: Chris Ball and Clare Wotton, November 1999
    Reviewer:

    Clinical Question.
    Patient paroxysmal supraventricular tachycardia
    Intervention or Exposure adenosine via a central vein
    Comparison adenosine via a peripheral vein
    Outcome termination of arrhythmia