Supraventricular tachycardia (SVT) is a dysrhythmia characterized rapid heart rate, typically with rapid onset. SVT accounts for over 50,000 emergency department visits per year. Of patients with regular, narrow-complex SVT, the mainstay of therapy includes adenosine and diltiazem. Adenosine is recommend by American and European guidelines as first-line therapy, however adenosine carries unique side effects that are potentially distressing to patients, including: "feeling of impending death or doom", flushing, anxiety, shortness of breath, and chest discomfort. Diltiazem does not carry this side effect profile, but has typically been reserved as second-line treatment due to side effects of low blood pressure associated with this class of medications. Diltiazem and adenosine have not been well studied head-to-head to compare safety and efficacy of their treatment for SVT. The purpose of this study is to evaluate safety and efficacy of adenosine and diltiazem for SVT in the ED (as completed through chart review of specific patient-level outcomes) and capture patient and clinician perspectives of medication satisfaction (through administration of questionnaires).
ED encounter for acute SVT
Age >/= 18 years
Receipt of IV adenosine and/or IV diltiazem for SVT in the ED or prehospital setting
Neurologic status precluding survey participation due to medical instability
Pregnant
Incarcerated
Non-English speaking
Adult patients (≥18 years of age) treated for SVT in the ED. The investigators will screen a convenience sample of adult patients presenting with stable SVT in the ED for study eligibility while study investigators (most often emergency medicine clinical pharmacists) are available to enroll participants and administer study questionnaires.
Cohort
Prospective
IV adenosine
DrugPatients will not be randomized to intervention but will be categorized based on the exposure of IV adenosine for treatment of SVT received prior to study enrollment
IV diltiazem
DrugPatients will not be randomized to intervention but will be categorized based on the exposure of IV diltiazem for treatment of SVT received prior to study enrollment
Patient satisfaction with SVT treatment
Patient satisfaction with treatment will be assessed using a Likert scale questionnaire of 1-5. Participants will indicate their satisfaction with treatment by indicating a score of 1-5, 1 being "not at all satisfied" and 5 being "extremely satisfied".
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