A retrospective analysis of cardioversion for paroxysmal supraventricular tachycardia in emergency department

Abstract

Objective To analyze retrospectively the cardioversion for paroxysmal supraventricular tachycardia(PSVT) in emergency department in order to explore rational guidance for the diagnosis and treatment for PSVT. Methods A retrospective analysis of PSVT patients in the emergency department admitted from June 2015 to December 2015 was carried out. First, all the patients were divided into two groups according to the cardioversion achieved by Valsalva’s maneuvre or not. Forty patients were enrolled in study. There were 11 patients got cardioversion successfully achieved by the Valsalva’s maneuvre and 29 patients failed to get cardioversion. Then, comparisons of demographics, vital sign, serum CTNI, potassium and NTproBNP level were carried out between these groups of patients using statistical analysis. The categorical variable was expressed in percentage and the continuous variable was described by mean±standard deviation and the comparisons of parameters were conducted by group t-test and chi-square test. Results The success rate of PSVT maneuvre cardioversion was 27.5%. In addition, there were no significant differences in demographics vital sign, TNI and NTproBNP between the two groups while there were significant differences in serum potassium level between the two groups [(3.8±0.4)mmol/L vs. (3.5±0.35)mmol/L P<0.05]. There was no significant difference in successful rate of cardioversion between the standard Valsalva’s maneuvre(n=6) the modified Valsalva’s maneuvre(n=5). The second-line treatment mainly included propafenone, adenosine, electroversion, verapamil and amiodarone. The propafenone was the most common second-line agent used for PSVT cardioversion accounting for 58.6%. Conclusions The success rate of Valsalva’s maneuver cardioversion was low. Keeping properly a higher level of serum potassium could increase the success rate of cardioversion by Valsalva’s maneuvre. Key words: Paroxysmal supraventricular tachycardia; Manoeuvre cardioversion; Modified Valsalva Manoeuvre; Propafenone; Electroversion; CTNI; NTproBNP