The Single-Syringe Versus the Double-Syringe Techniques of Adenosine Administration for Supraventricular Tachycardia: A Systematic Review and Meta-Analysis,American Journal of Cardiovascular Drugs

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The Single-Syringe Versus the Double-Syringe Techniques of Adenosine Administration for Supraventricular Tachycardia: A Systematic Review and Meta-Analysis
American Journal of Cardiovascular Drugs ( IF 2.8 ) Pub Date : 2023-05-10 , DOI: 10.1007/s40256-023-00581-w
Isabele A Miyawaki ₁ , Cintia Gomes ₁ , Vittoria Caporal S Moreira ₂ , Isabela R Marques ₃ , Isabela A F de Souza ₁ , Caroliny H A Silva ₄ , José Eduardo Riceto Loyola Júnior ₁ , Kangwook Huh ₅ , Marc McDowell ₆ , Eduardo M H Padrao ₅ , Matthew B Tichauer _{5,

7} , Charles Michael Gibson ₈

Affiliation

Introduction

The intravenous double-syringe technique (DST) of adenosine administration is the first-line treatment for stable supraventricular tachycardia (SVT). Alternatively, the single-syringe technique (SST) was recently found to be potentially beneficial in several studies. This study aimed to perform a meta-analysis of the SST versus the DST of adenosine administration for the treatment of SVT.

Methods

We assessed EMBASE, PubMed, Cochrane, and ClinicalTrials.gov databases for randomized controlled trials (RCTs) and non-randomized studies of intervention (NRSIs) comparing the DST to the SST of adenosine administration in patients with SVT. Outcomes included termination rate, termination rate at first dose, total administered dose, adverse effects, and discharge rate.

Results

We included four studies (three RCTs and one NRSI) with a total of 178 patients, of whom 99 underwent the SST of adenosine administration. No significant difference was found between treatment groups regarding termination rate, termination rate restricted to RCTs, total administered dose, and discharge rate. Termination rate at first dose (odds ratio 2.87; confidence interval 1.11–7.41; p = 0.03; I² = 0%) was significantly increased in patients who received the SST. Major adverse effects were observed in only one study.

Conclusions

The SST is probably as safe as the DST and at least as effective for SVT termination, SVT termination at first dose, and discharge rate from the emergency department. However, definitive superiority of one technique is not feasible given the limited sample size.

Registration

PROSPERO identifier nº CRD42022345125.

中文翻译：

单注射器与双注射器腺苷注射技术治疗室上性心动过速：系统评价和荟萃分析

介绍

腺苷静脉双注射技术（DST）是稳定型室上性心动过速（SVT）的一线治疗方法。另外，最近在多项研究中发现单注射器技术 (SST) 具有潜在的益处。本研究旨在对腺苷给药治疗 SVT 的 SST 与 DST 进行荟萃分析。

方法

我们评估了 EMBASE、PubMed、Cochrane 和 ClinicalTrials.gov 数据库中的随机对照试验 (RCT) 和非随机干预研究 (NRSI)，比较了 SVT 患者腺苷给药的 DST 和 SST。结果包括终止率、首次给药终止率、总给药剂量、不良反应和出院率。

结果

我们纳入了四项研究（三项随机对照试验和一项 NRSI），共有 178 名患者，其中 99 名患者接受了腺苷注射 SST。治疗组之间在终止率、仅限于随机对照试验的终止率、总给药剂量和出院率方面没有发现显着差异。接受 SST 的患者首次给药时的终止率（比值比 2.87；置信区间 1.11–7.41；p = 0.03；I ^{2 = 0%）显着增加。}仅在一项研究中观察到主要不良反应。