Clinical Analysis of ATP Therapeutic Efficacy in 144 Cases of Paroxysmal Supraventricular Tachycardia in the Emergency Department

XU Yuxiang; TAN Qingzhao

doi:10.13919/j.issn.2095-6274.ZHJY20250901

Abstract：Objective To investigate the efficacy and safety of adenosine triphosphate(ATP)in the emergency treatment of paroxysmal supraventricular tachycardia(PSVT),and to analyze the impact of age,heart rate,and anxiety state on the outcome of ATP cardioversion,aiming to provide references for individualized emergency management.Meth-ods A retrospective analysis was conducted on 144 PSVT patients admitted to the emergency department of our hospital from February 2023 to December 2024,all of whom received intravenous ATP treatment.Patients were divided into an effective group(124 cases)and an ineffective group(20 cases)based on cardioversion outcome.Baseline characteristics were compared between the two groups,and multivariate logistic regression analysis was used to identify independent risk factors for failed ATP cardioversion.Results The overall successful cardioversion rate with ATP was 86.11%(124/144).The incidence of adverse reactions was 20.83%(30/144),all of which were transient.Univariate analysis showed that the heart rate and Generalized Anxiety Disorder-2(GAD-2)scores were significantly higher in the ineffective group compared to the effective group(all P<0.05).Stratified analysis indicated that the successful cardioversion rate was significantly low-er in patients aged≥70 years,with a heart rate≥180 beats/min,and with a GAD-2 score≥3(all P<0.05).Multivariate regression analysis identified age≥70 years(OR=5.220,95%CI:1.042～26.149),heart rate≥180 beats/min(OR=6.018,95%CI:1.702～21.285),and GAD-2 score≥3(OR=3.972,95%CI:1.338～11.788)as independent risk factors for failed ATP cardioversion.Conclusion ATP is a safe and effective drug for terminating PSVT in the emergency setting.Ad-vanced age,extremely fast heart rate,and concomitant anxiety state may be high-risk factors predicting ATP cardioversion failure.In emergency management,enhanced monitor-ing and consideration of alternative treatment options are warranted for such high-risk patients to optimize management strategies.