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1 Analysis of Factors Predicting Recurrence and the Result of Treatment in PSVT Patients at the Emergency Department Byeong Jo Chun, M.D., Jung Mi Moon, M.D., Joon Sun Wi, M.D., Kyoung Woon Jeoung, M.D., Hyun Chang Kim, M.D., Seung Tae Jeong, M.D., Tag Heo, M.D., Young Il Min, M.D. P u r p o s e: The purpose of this research was to evaluate the factors predicting recurrence and the characteristics of patients who recurred after the treatment of spontaneous paroxysmal supraventricular tachycardia (PSVT) with a d e n o s i n e. M e t h o d s: From January 1999 to December 2001, 62 patients with PSVT were enrolled in this study. The conversion group included patients who had had a therapeutic response, which was defined as the occurrence of a change in the sinus rhythm after adenosine administration. The recurred group consisted of all patients who had not had a therapeutic response. Clinical features, the results of treatment, ECG findings, and the hemodynamic statuses were analyzed. R e s u l t s: The treatments were vagal maneuver (5 pts, 7.5 ), adenosine 6 mg (37 pts, 55.2), adenosine 12 mg (14 pts, 20.9), verapamil 5 mg (9 pts, 13.4), and cardioversion (2 pts, 3.0). Twenty-five of the 62 patients failed to have a therapeutic response, yielding a recurrence rate of Atrioventricular reentrant tachycardia (AVRT) was more prevalent in the recurred group. The most common symptom at presentation was chest pain. The recurred group had increased heart rate, and increased blood pressure. When patients were monitered after adenosine, unifocal premature ventricular complex was the most common rhythm encountered in the conversion group, but atrial fibrillation, and multifocal premature ventricular complex was the most common rhythm encountered. C o n c l u s i o n: Age, heart rate, difference in systolic blood pressure from presentation to discharge, previous history of heart disease, and rhythms encountered after adenosine administration were factors predicting recurrence. Key Words: Paroxysmal supraventricular tachycardia (PSVT), Recurrence, Predicting factors Department of Emergency Medicine, Chonnam National University College of Medicine, Kwangju, Korea 416

recurred after the treatment of spontaneous paroxysmal supraventricular tachycardia (PSVT) with a d e n o s i n e.

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Akhtar MA, Jazayeri MR, Sra J: Atrioventricular nodal reentry. Clinical electrophysiology and therapeutic consid- Circulation 88:282-95, 1993. eration. 14.

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Camm AJ, Garratt C: Adenosine and supraventricular tachycardia. N Engl J Med. 325:1621-9, 1991. 12. Belardinelli L, Curtis AB, Bertolet B. In: Jacobson KA, Jarvis MF, eds.

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ºÎÁ¤¸ÆV10N³»Áö A case of atrioventricular dissociation with interference ABSTRACT Interference dissociation is one of the most interesting arrhythmias. Once thought to be a rare arrhythmia, it is now considered a very