Adenosine and other interventions show variable success in adult paroxysmal supraventricular tachycardia patients.

ObjectivesThis study aimed to evaluate the clinical characteristics, symptom presentation, and management outcomes of patients diagnosed with paroxysmal supraventricular tachycardia (PSVT) at King Hamad University Hospital (KHUH), a tertiary care center. It examined the influence of demographics, comorbidities, and sex on treatment responses to pharmacologic and non-pharmacologic interventions, including cardioversion.MethodsA retrospective observational study was conducted on 427 adult patients with PSVT (ICD-10: I47.1, confirmed by chart review) between January 2018 and early 2024. Data were extracted from the KHUH HOPE electronic medical records system. Descriptive statistics summarized baseline characteristics; chi-square tests examined categorical associations. Kaplan–Meier analyses for the cardioversion subgroup (n = 18) are presented as exploratory and descriptive only.ResultsFemales comprised 56.9% of the cohort (mean age 52.8 ± 15.2 years). Palpitations were the most common symptom (94.4%). Of 219 patients who received adenosine, 177 (80.8%) achieved cardioversion with the first dose, 25 (11.4%) with the second, and 17 (7.8%) with the third. Vagal maneuvers showed reduced success in patients with structural heart disease and diabetes mellitus. Electrical cardioversion was required in 18 patients (4.2%). Pacemaker implantation was documented in 3 patients (0.7%) for co-existing conduction disease, not as a PSVT treatment. Comorbidities significantly influenced outcomes: hypertension was associated with favorable vagal maneuver response, while heart failure and ischemic heart disease correlated with poor response across all modalities.ConclusionPSVT generally responds well to first-line treatments. However, individualized strategies are warranted for patients with structural heart disease or significant comorbidities. Observed sex-based and age-related response differences are descriptive and require multivariable validation.