Comparison of Single-syringe vs. Double-syringe Techniques for Adenosine Administration in PSVT

Comparison of Single-syringe vs. Double-syringe Techniques for Adenosine Administration in Supraventricular Tachycardia: A Randomized Clinical Trial

The purpose of the study is to compare the effectiveness of two different methods of administering adenosine for the treatment of stable supraventricular tachycardia (SVT).

Study Overview

• Status: Completed
• Conditions: Supraventricular Tachycardia; Supraventricular Arrhythmia; SVT; Supraventricular Tachycardias; PSVT
• Intervention / Treatment: Drug: Single-syringe Adenosine; Drug: Double Syringe Adenosine

Detailed Description

The American Heart Association 2015 guidelines recommend adenosine for non-hypotensive patients with regular narrow complex SVT. Adenosine is usually given as a rapid intravenous bolus of 6mg over 1-2 seconds, followed by a 20ml saline flush. If the first dose does not result in the termination of SVT to normal sinus rhythm (NSR) within 1-2 minutes, a repeat dose of 12mg can be given, and the dose may be repeated one more time, if necessary, for a total of three doses.

The double-syringe technique (DST) is the standard method for administering adenosine. However, recent studies suggest that the single-syringe technique (SST) may be simpler and potentially beneficial. This technique injects adenosine and saline simultaneously at the same time instead of two separate injections. The study aims to determine if the SST method is non-inferior to the DST method.

• Study Type: Interventional
• Enrollment (Actual): 131
• Phase: Phase 4

Contacts and Locations

Study Locations

• Iran
  • Bandar Abbas, Iran
    • Shahid Mohammadi Hospital
  • Hormozgan
    • Bandar Abbas, Hormozgan, Iran
      • Shahid Mohammadi Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age 18 to 80 years
• Presentation to the emergency department with narrow-QRS tachyarrhythmia
• Heart rate ≥150 beats/min
• No visible P wave or presence of retrograde P wave on ECG
• Not responsive to Valsalva maneuvers lasting 15 to 30 seconds
• Requiring adenosine administration

Exclusion Criteria:

• Wide-QRS tachycardia or irregular R-R interval on ECG
• Known allergy or contraindication to adenosine
• Recent ingestion of dipyridamole, carbamazepine, or theophylline
• Caffeine ingestion within the previous 2 hours

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Single-syringe technique (SST)	Drug: Single-syringe Adenosine; Simplified method, containing both 6 mg of adenosine and 18 mL NS. If SVT termination failed: Second dose of adenosine with SS containing both 12 mg of adenosine and 18 mL NS. A total of three doses could be provided to each patient
Active Comparator: Double-syringe technique (DST)	Drug: Double Syringe Adenosine; One Syringe containing 6 mg of adenosine + one syringe containing 20 mL NS aided with a stopcock. If SVT termination failed: Second dose of adenosine (12 mg) + one syringe containing 20 mL NS. A total of three doses could be provided to each

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
First-dose successful termination of PSVT	Proportion of participants with conversion from paroxysmal supraventricular tachycardia to sinus rhythm after the first dose of adenosine.	Within 2 minutes after administration of the first dose of adenosine.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total administered dose of adenosine.	Total cumulative dose of adenosine (mg) administered to achieve termination of PSVT.	From administration of the first dose until successful termination of PSVT or up to 10 minutes, whichever occurs first.

Collaborators and Investigators

• Sponsor: Hormozgan University of Medical Sciences

Study record dates

Study Major Dates

• Study Start (Actual): May 21, 2024
• Primary Completion (Actual): December 21, 2025
• Study Completion (Actual): December 21, 2025

Study Registration Dates

• First Submitted: February 6, 2026
• First Submitted That Met QC Criteria: April 23, 2026
• First Posted (Actual): April 28, 2026

Study Record Updates

• Last Update Posted (Actual): April 28, 2026
• Last Update Submitted That Met QC Criteria: April 23, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Cardiovascular Diseases; Cardiac Arrhythmias; Supraventricular Tachycardia; SVT; Single syringe; Single-syringe
• Additional Relevant MeSH Terms: Cardiac Conduction System Disease; Pathologic Processes; Heart Diseases; Tachycardia; Pathological Conditions, Signs and Symptoms; Cardiovascular Diseases; Tachycardia, Supraventricular; Arrhythmias, Cardiac
• Other Study ID Numbers: SVT management techniques

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No