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Adenosine or Verapamil for the Acute Treatment of Supraventricular Tachycardia?

Andrew C. Rankin, MD; and Brian A. McGovern, MD
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Massachusetts General Hospital
Boston, MA 02114

Ann Intern Med. 1991;114(6):513-515. doi:10.7326/0003-4819-114-6-513
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Adenosine, an endogenous, rapidly metabolized, purine nucleoside, was approved recently by the Food and Drug Administration for intravenous use in patients with paroxysmal supraventricular tachycardia. It acts through extracellular adenosine receptors and causes transient slowing or block of atrioventricular nodal conduction (1, 2). This process results in the termination of most supraventricular tachycardias that use a re-entrant circuit that includes the atrioventricular node (2-5). Adenosine's duration of action in humans is typically less than 1 minute, because of rapid cellular uptake and enzymatic breakdown (6). This brevity of action is an advantage, because adverse effects should be correspondingly brief. Adenosine


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