{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T02:08:41Z","timestamp":1794535721016,"version":"4.9.1"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Supraventricular tachycardia (SVT) is the most common arrhythmia in the pediatric population. Adenosine is widely accepted as the first-line pharmacological treatment for hemodynamically stable SVT, constituting a class I recommendation in the 2020 American Heart Association guidelines for pediatric life support (2020 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care). As most pediatric SVTs are dependent on the atrioventricular node (AVN) for their propagation, and adenosine acts primarily on the AVN, adenosine will frequently terminate the arrhythmia. The term \u201cadenosine failure\u201d is often used to describe when its administration does not result in sustained termination of the tachycardia. Because of its very short half-life, there is confusion between improper delivery, failure to have any effect on the tachycardia, or transient termination. There are some pediatric SVTs, which are not AVN dependent, and which truly are refractory to adenosine. Simultaneous electrocardiogram recording during administration can provide important information to differentiate between adenosine resistance and transient adenosine effect, thus guiding further management.<\/jats:p>","DOI":"10.1097\/pec.0000000000002701","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T17:06:20Z","timestamp":1651165580000},"page":"235-240","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["When Adenosine Does Not Work"],"prefix":"10.1097","volume":"38","author":[{"given":"Jennifer","family":"Shortland","sequence":"first","affiliation":[{"name":"Clinical Fellows"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakethram","family":"Saravu Vijayashankar","sequence":"additional","affiliation":[{"name":"Clinical Fellows"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhayan","family":"Sanatani","sequence":"additional","affiliation":[{"name":"Professor of Pediatrics and Pediatric Cardiologist and Electrophysiologist, BC Children\u2019s Hospital Heart Centre, Department of Pediatric Cardiology, University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/BF02724188","article-title":"Supraventricular tachycardia in children","volume":"72","year":"2005","journal-title":"Indian J Pediatr"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jpeds.2016.10.051","article-title":"Acute management of refractory and unstable pediatric supraventricular tachycardia","volume":"181","year":"2017","journal-title":"J Pediatr"},{"issue":"suppl 1","key":"bib3-20250504","article-title":"Arrhythmias of children in the emergency department: incidence, management and outcome","volume":"95","journal-title":"Arch Dis Child"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1001\/archpediatrics.2008.547","article-title":"Supraventricular tachycardia","volume":"163","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/0002-9149(94)90089-2","article-title":"Therapeutic and diagnostic utility of adenosine during tachycardia evaluation in children","volume":"74","year":"1994","journal-title":"Am J Cardiol"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"262","DOI":"10.2174\/1573403X10666140514103309","article-title":"Current algorithms for the diagnosis of wide QRS complex tachycardia","volume":"10","year":"2014","journal-title":"Curr Cardiol Rev"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC)","volume":"41","year":"2020","journal-title":"Eur Heart J"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.ipej.2019.09.004","article-title":"Neonatal supraventricular tachycardia","volume":"19","year":"2019","journal-title":"Indian Pacing Electrophysiol J"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1093\/europace\/eut082","article-title":"Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-arrhythmia working group joint consensus statement","volume":"15","year":"2013","journal-title":"Europace"},{"issue":"16 suppl 2","key":"bib10-20250504","first-page":"469","article-title":"Pediatric Basic and Advanced Life Support Collaborators. 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An evaluation of its use in cardiac diagnostic procedures, and in the treatment of paroxysmal supraventricular tachycardia","volume":"41","year":"1991","journal-title":"Drugs"},{"key":"bib15-20250504","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/clc.4960140202","article-title":"Adenosine: clinical pharmacology and applications","volume":"14","year":"1991","journal-title":"Clin Cardiol"},{"key":"bib16-20250504","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1136\/adc.2005.077636","article-title":"Guidelines and adenosine dosing in supraventricular tachycardia","volume":"90","year":"2005","journal-title":"Arch Dis Child"},{"key":"bib17-20250504","first-page":"451","article-title":"Pitfalls in the use of adenosine","volume":"91","year":"2006","journal-title":"Arch Dis Child"},{"key":"bib18-20250504","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC guidelines for the management of patients with supraventricular tachycardia. 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