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Risk of bias was assessed with ROBINS-I and certainty of evidence with GRADE. Logit-transformed cardioversion proportions were pooled using a three-level random-effects model to account for clustering of multiple bolus administrations within studies.\u00a0Successful cardioversion to sinus rhythm following an individual intravenous adenosine bolus.\u00a0Conversion probability increased across prespecified weight-based dose categories: 25% (95% CI, 14%-40%) at doses\u2009&lt;\u2009100\u00a0\u00b5g\/kg, 38% (95% CI, 31%-46%) at 100\u00a0\u00b5g\/kg, 47% (95% CI, 39%-55%) at 150\u2013225\u00a0\u00b5g\/kg, and 59% (95% CI, 48%-69%) at 250\u2013400\u00a0\u00b5g\/kg. In the three-level model, overall conversion probability was 41% (95% CI, 35% to 47%). Increasing dose was associated with higher odds of cardioversion (\u03b2\u2009=\u20090.0054 per \u00b5g\/kg; OR per 100\u00a0\u00b5g\/kg, 1.72 [95% CI, 1.43 to 2.07];\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .001), with residual heterogeneity primarily attributable to between-study variability.\u00a0Higher weight-based adenosine doses were consistently associated with greater conversion probability across observational cohorts. These findings suggest that commonly used initial doses may underperform in many children and justify prospective trials evaluating mechanism-specific initial dosing strategies.\n                  <\/jats:p>","DOI":"10.1007\/s00246-026-04281-5","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:07:32Z","timestamp":1780632452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adenosine Dose and Cardioversion in Pediatric Supraventricular Tachycardia: A Systematic Review and Meta-Analysis"],"prefix":"10.1007","author":[{"given":"La\u00eds","family":"dos Santos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tha\u00eds Martins","family":"Shehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candela","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Sanchez","family":"Algarin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid Bezerra","family":"de Oliveira Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Cesar Mattos Dourado","family":"de Mesquita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Dagostin","family":"de Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"3","key":"4281_CR1","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1001\/archpediatrics.2008.547","volume":"163","author":"JC Salerno","year":"2009","unstructured":"Salerno JC, Seslar SP (2009) Supraventricular tachycardia. 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