Current practices and knowledge of adenosine administration for paroxysmal supraventricular tachycardia: a multi-province survey in Chinese emergency departments

Abstract

Background: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in emergency departments, with adenosine recommended as the first-line therapy in international guidelines. However, its adoption remains limited in China due to accessibility challenges, cost concerns, and entrenched reliance on traditional antiarrhythmics. Aim: This study aimed to assess the current utilization of adenosine for PSVT in Chinese emergency departments, identify barriers to guideline adherence, and evaluate physicians’ knowledge of adenosine administration. Methods: A cross-sectional survey was conducted among 988 emergency physicians across 10 Chinese provinces from July 1 to July 31, 2024. The questionnaire, distributed via WeChat, collected demographic data, treatment preferences, and knowledge of adenosine’s contraindications and side effects. Statistical analysis was performed using GraphPad Prism 9.5.0.730, with chi-square tests for group comparisons. Results: 34.6% of physicians reported adenosine use, contrasting with higher utilization of amiodarone (63.77%) and propafenone (55.77%). Limited accessibility was evident: 53.74% of hospitals stocked adenosine, and only 55.18% of emergency departments maintained consistent supplies. While 58.57% of respondents correctly identified the 6 mg IV bolus dose, knowledge gaps persisted for contraindications and side effects. Attending physicians demonstrated lower protocol adherence than residents and chiefs (P < 0.01). Conclusions: Emergency physicians, especially those in charge, have a limited understanding of SVT and the appropriate use of adenosine, necessitating further training for this demographic.