responded to poor efficacy diltiazem for terminating while only PSVT, even 4/16 pts when 2 responded to boluses are esmolol administered. (p<0.001) Of the 28 pts who responded to diltiazem, in 13 pts the second bolus of diltiazem worked after the first had failed. Alboni P 33 Flecainide Placebo AVNRT and AVRT Preexcitation, CAD, Conversion to Four pts (1 N/A N/A Use of these 2001 (n=33) (n=33) confirmed by EP study resting bradycardia sinus rhythm placebo, 1 agents is (36) <50 bpm, LVEF occurred w/in diltiazem/ efficacious in Well-tolerated (no sxs <50%, h/o HF, 2 h in 52%, propranolol, acute therapy, to Diltiazem/ of dyspnea, syncope, severe “general 61%, and and 2 both w/ propranolol presyncope, no diseases,” recent MI 94% of pts on flecainide) had and of (n=33) interference w/ normal or CVA, acute placebo, hypotension outpt therapy. PSVT, activities illness, need for flecainide and and four (3 However, only AADs, h/o sustained diltiazem/ diltiazem/ 4/5 pts Infrequent (≤5 atrial/ventricular propranolol, propranolol and discharged on episodes/y) w/ ≥1 ED tachyarrhythmias respectively 1 flecainide) a flecainide. visit/y (p<0.001) sinus rate <50 Complications bpm following not trivial and PSVT documented by The SVT all pts ECG conversion interruption w/ EP time was study. shorter after diltiazem/ propranolol (32±22 min) than after placebo (77±42 min, p<0.001) or flecainide (74± 37 min, p<0.001). 26 pts discharged on
responded to diltiazem while only 4/16 pts responded to esmolol (p<0.001) Of the 28 pts who responded to diltiazem, in 13 pts the second bolus of diltiazem worked after the first had failed. poor efficacy for terminating PSVT, even when 2 boluses are administered. Alboni P 2001 (36) to of PSVT, 33 Flecainide (n=33) Diltiazem/ propranolol (n=33) Placebo (n=33) AVNRT and AVRT confirmed by EP study Well-tolerated (no sxs of dyspnea, syncope, presyncope, no interference w/ normal activities Infrequent (≤5 episodes/y) w/ ≥1 ED visit/y PSVT documented by ECG Preexcitation, CAD, resting bradycardia <50 bpm, LVEF <50%, h/o HF, severe “general diseases,” recent MI or CVA, acute illness, need for AADs, h/o sustained atrial/ventricular tachyarrhythmias Conversion to sinus rhythm occurred w/in 2 h in 52%, 61%, and 94% of pts on placebo, flecainide and diltiazem/ propranolol, respectively (p<0.001) The conversion time was shorter after diltiazem/ propranolol (32±22 min) than after placebo (77±42 min, p<0.001) or flecainide (74± 37 min, p<0.001). 26 pts discharged on Four pts (1 placebo, 1 diltiazem/ propranolol, and 2 flecainide) had hypotension and four (3 diltiazem/ propranolol and 1 flecainide) a sinus rate <50 bpm following SVT interruption N/A N/A Use of these agents is efficacious in acute therapy, both w/ and outpt therapy. However, only 4/5 pts discharged on flecainide. Complications not trivial and all pts w/ EP study.
2015_SVT_Evidence_Tables_Data_Supplement.docx