Adenosine for the Treatment of Paroxysmal Supraventricular Tachycardia in Full-Term and Preterm Newborn Infants

Adenosine has been approved for intravenous use for paroxysmal supraventricular tachycardias (SVT) in adults and children. However, effectiveness and safety of intravenous adenosine in preterm infants are not well established. Thirteen episodes of SVT in three preterm and two full-term neonates were treated with intravenous adenosine. All had narrow QRS tachycardia at 230 to 260 beats/min. Adenosine prepared as a sterile 1 mg/mL solution was given as an intravenous bolus starting at 0.05 mg/kg, and increased by 0.05 mg/kg until tachycardia was terminated. Termination of tachycardia was achieved within 12 to 25 seconds in all patients. In one, termination of SVT was followed by temporary suppression of the sinus node, followed by resumption of normal sinus rhythm. No other side effects were noted. Adenosine is a safe and effective agent for treating preterm infants with SVT. However, further investigation of adenosine in this group of patients is warranted.