Cardiac arrest & resuscitation
Prehospital management of supraventricular tachycardia: a multicentre study of current practices with a subgroup propensity score-based comparison of adenosine and electrical cardioversion in unstable patients
Main finding · Successful cardioversionResult — go to the resultWeighted odds ratio 2.41 95 % CI 1.01–7.14Authors' conclusion
In patients with prehospital SVT, adenosine is the preferred cardioversion strategy. In unstable cases, adenosine may be a safe first-line attempt before ECV, potentially reducing sedation-related risks.
Study context
- Population
- Prehospital supraventricular tachycardia (SVT) events, three Italian physician-staffed Emergency Medical Services, 2019–2024
- Participants
- 1,234 SVT events
- Exposure
- Adenosine vs electrical cardioversion for prehospital SVT
- Adenosinen = 763reference
- Electrical cardioversion (ECV)n = 56
- Outcome
- Rate of successful cardioversion
Methodological detailsmulticentre, propensity score-weighted
- Multicentre
- Propensity score-weighted
Main finding
Successful cardioversion
Weighted odds ratio
2.41
95 % CI 1.01–7.14
By group
ECV vs Adenosine
weighted OR 2.41 (95 % CI 1.01–7.14)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
- ECG diagnostic accuracy
- 90.7 %
- Dangerous misdiagnosis (eg VT) in available ECG readings
- fewer than 2 %
Safety
Events
| Outcome | Adenosine | ECV |
|---|---|---|
| Life-threatening complications after cardioversion | 0 | 0 |
Life-threatening complications after cardioversion
- More frequent sedative use with ECV vs adenosine
Original publication
Prehospital management of supraventricular tachycardia: a multicentre study of current practices with a subgroup propensity score-based comparison of adenosine and electrical cardioversion in unstable patients. Resuscitation. Published 7 July 2025. doi:10.
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