Sert Ekrem Taha, Kokulu Kamil, Mutlu Hüseyin, Gönen Mustafa Önder, Sert Zekiye Soykan
Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey.
Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey.
J Emerg Med. 2025 Jul;74:54-62. doi: 10.1016/j.jemermed.2025.02.006. Epub 2025 Feb 7.
Paroxysmal supraventricular tachycardia (SVT) is a recurrent tachydysrhythmia that often leads to emergency department (ED) visits and is commonly treated with intravenous adenosine.
The objective of this paper is to evaluate the relationship between the initial ionized calcium (iCa) level and the achievement of normal sinus rhythm following 6 mg adenosine administration in patients with SVT.
This retrospective, single-center study was conducted in the ED from 2019 to 2023 and included consecutive adult patients diagnosed with SVT who received adenosine treatment. The patients were categorized into two groups based on their response to adenosine treatment. The receiver operating characteristic (ROC) curves were constructed to evaluate the effectiveness of iCa levels in predicting conversion to sinus rhythm.
A total of 326 patients were analyzed. The mean iCa level in patients who achieved a sinus rhythm after the initial 6-mg dose was 1.13 ± 0.08 mmol/L, as compared to 1.03 ± 0.11 mmol/L in those who did not respond to this dose, indicating a statistically significant difference (mean difference [95% confidence interval (CI)]: -0.101 [-0.12 to -0.07]). The area under the ROC curve was calculated to be 0.803 (95% CI: 0.752-0.854). An iCa cut-off value of 1.14 mmol/L was determined to be significant for the prediction of achieving sinus rhythm, with a sensitivity of 64.75% (95% CI: 55.6-73.2) and a specificity of 87.75% (95% CI: 83.6-92.7).
Our study suggests that the iCa level may be a useful parameter for predicting the response to the 6 mg adenosine dose in patients with SVT.
阵发性室上性心动过速（SVT）是一种反复发作的快速性心律失常，常导致患者前往急诊科就诊，且通常采用静脉注射腺苷进行治疗。
本文旨在评估SVT患者静脉注射6 mg腺苷后初始离子钙（iCa）水平与恢复正常窦性心律之间的关系。
本回顾性单中心研究于2019年至2023年在急诊科开展，纳入连续诊断为SVT并接受腺苷治疗的成年患者。根据患者对腺苷治疗的反应将其分为两组。构建受试者工作特征（ROC）曲线以评估iCa水平预测转为窦性心律的有效性。
共分析了326例患者。初始6 mg剂量后恢复窦性心律的患者平均iCa水平为1.13±0.08 mmol/L，而对该剂量无反应的患者平均iCa水平为1.03±0.11 mmol/L，差异具有统计学意义（平均差值[95%置信区间（CI）]：-0.101[-0.12至-0.07]）。计算得出ROC曲线下面积为0.803（95%CI：0.752 - 0.854）。确定iCa临界值为1.14 mmol/L对预测恢复窦性心律具有显著意义，敏感性为64.75%（95%CI：55.6 - 73.2），特异性为87.75%（95%CI：83.6 - 92.7）。
我们的研究表明，iCa水平可能是预测SVT患者对6 mg腺苷剂量反应的有用参数。
