Scolaris Content Display Scolaris Content Display

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Adenosine vs CCA, Outcome 1 Odds of reversion.
Figures and Tables -
Analysis 1.1

Comparison 1 Adenosine vs CCA, Outcome 1 Odds of reversion.

Comparison 1 Adenosine vs CCA, Outcome 2 Time to reversion (seconds).
Figures and Tables -
Analysis 1.2

Comparison 1 Adenosine vs CCA, Outcome 2 Time to reversion (seconds).

Comparison 1 Adenosine vs CCA, Outcome 3 Relapse to SVT post reversion.
Figures and Tables -
Analysis 1.3

Comparison 1 Adenosine vs CCA, Outcome 3 Relapse to SVT post reversion.

Comparison 1 Adenosine vs CCA, Outcome 4 Minor adverse events.
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Analysis 1.4

Comparison 1 Adenosine vs CCA, Outcome 4 Minor adverse events.

Comparison 1 Adenosine vs CCA, Outcome 5 Hypotension.
Figures and Tables -
Analysis 1.5

Comparison 1 Adenosine vs CCA, Outcome 5 Hypotension.

Summary of findings for the main comparison. Adenosine compared with calcium channel antagonists for supraventricular tachycardia

Adenosine compared with calcium channel antagonists for supraventricular tachycardia

Patient or population: patients with supraventricular tachycardia
Setting: emergency department
Intervention: adenosine
Comparison: calcium channel antagonists (CCAs)

Outcomes

Number of

participants

Number

of studies

Odds ratio
(95% CI)

Absolute effects (95% CI)

Follow‐up

Quality of the evidence
(GRADE)

What happens

With adenosine

With CCA

Difference

Odds of reversion

622

7 RCTs

OR 1.51

(0.85 to 2.68)

89.7%

92.9%
(88.1 to 95.9

3.2% lower odds of reversion with adenosine
(95% CI 1.2 lower to 6.2 lower)

Until reversion occurred
or predetermined maximum dose was reached

⊕⊕⊕⊝
MODERATEa

Higher odds of reversion indicate better effect.

Major adverse event:
hypotension

306

3 RCTs

OR 3.09
(0.12 to 76.71)

0.0%

0.0%

(0.0 to 0.0)

0.0% fewer

(0 fewer to 0 fewer)

Up to 2 hours after infusion

⊕⊕⊝⊝
LOWa,b

Lower hypotension rate indicates fewer adverse events.

Length of stay in hospital

Not reported

0

Patient satisfaction

Not reported

0

CI: confidence interval; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect,
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

aQuality of the evidence downgraded by one level for imprecision. Moderate to wide confidence intervals.

bQuality of the evidence downgraded by one level for study limitations. Judgements of high risk of bias in all studies, as none of the studies were blinded.

Figures and Tables -
Summary of findings for the main comparison. Adenosine compared with calcium channel antagonists for supraventricular tachycardia
Comparison 1. Adenosine vs CCA

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Odds of reversion Show forest plot

7

622

Odds Ratio (M‐H, Fixed, 95% CI)

1.51 [0.85, 2.68]

2 Time to reversion (seconds) Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Relapse to SVT post reversion Show forest plot

4

358

Odds Ratio (M‐H, Fixed, 95% CI)

0.38 [0.09, 1.69]

4 Minor adverse events Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Chest tightness

3

222

Odds Ratio (M‐H, Fixed, 95% CI)

0.09 [0.02, 0.50]

4.2 Shortness of breath

2

171

Odds Ratio (M‐H, Fixed, 95% CI)

0.23 [0.04, 1.37]

4.3 Flushing

1

50

Odds Ratio (M‐H, Fixed, 95% CI)

0.01 [0.00, 0.24]

5 Hypotension Show forest plot

3

306

Odds Ratio (M‐H, Fixed, 95% CI)

3.09 [0.12, 76.71]

Figures and Tables -
Comparison 1. Adenosine vs CCA