Abstract | BACKGROUND: METHODS AND RESULTS: Patients with a history of symptomatic PSVT and inducible PSVT at the time of a clinically indicated electrophysiology study were randomized into a multicenter, double-blind, placebo-controlled trial. Five 2-dose tecadenoson bolus regimens were evaluated versus placebo (75/150, 150/300, 300/600, 450/900, 900 microg/900 microg). The second bolus was administered only if PSVT persisted for 1 minute after the first bolus. Each tecadenoson regimen resulted in a significant therapeutic conversion rate compared with placebo (range, 50.0% to 90.3%, analysis of all patients dosed; n=181; P<0.0005). Conversion by the first bolus was dose related (range: placebo, 3.3% to 86.7% for 900 microg/900 microg). Time to conversion was dose dependent, with a median time of <1 minute for the 3 highest dose regimens. Postconversion arrhythmias were transient, requiring no additional treatment in 4 regimens (including placebo). Transient second- and third-degree heart block occurred at higher doses (300/600, 450/900, 900 microg/900 microg) and was supported with backup pacing when needed. No effect on blood pressure was observed. Ten patients with a history of asthma or chronic obstructive pulmonary disease tolerated tecadenoson without bronchospasm. CONCLUSIONS: We identified an optimal tecadenoson regimen (300 microg/600 microg) that effectively and rapidly converted 90% (28 of 31) of PSVT patients to normal sinus rhythm with no significant adverse effects.
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Authors | Kenneth A Ellenbogen, Gearoid O'Neill, Eric N Prystowsky, John A Camm, Lixin Meng, Hsiao Dee Lieu, Markus Jerling, Revati Shreeniwas, Luiz Belardinelli, Andrew A Wolff, TEMPEST Study Group |
Journal | Circulation
(Circulation)
Vol. 111
Issue 24
Pg. 3202-8
(Jun 21 2005)
ISSN: 1524-4539 [Electronic] United States |
PMID | 15956124
(Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Adenosine A1 Receptor Agonists
- Furans
- tecadenoson
- Adenosine
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Topics |
- Adenosine
(administration & dosage, analogs & derivatives, pharmacokinetics)
- Adenosine A1 Receptor Agonists
- Adult
- Aged
- Blood Pressure
(drug effects)
- Disease Management
- Dose-Response Relationship, Drug
- Double-Blind Method
- Electrophysiology
- Female
- Furans
(administration & dosage, pharmacokinetics)
- Heart Arrest
(chemically induced)
- Heart Rate
(drug effects)
- Humans
- Male
- Middle Aged
- Pericardial Effusion
(chemically induced)
- Syncope
(chemically induced)
- Tachycardia, Supraventricular
(drug therapy, physiopathology)
- Time Factors
- Treatment Outcome
- Venous Thrombosis
(chemically induced)
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