# Successful Intraosseous (IO) Adenosine Administration for the Termination of Supraventricular Tachycardia (SVT) in a 3.5-Year-Old Child—Case Report and Literature Review

## TL;DR

A 3.5-year-old child with SVT was successfully treated using adenosine administered via the intraosseous route, achieving normal heart rhythm without recurrence.

## Contribution

This case report demonstrates the successful use of intraosseous adenosine for SVT termination in a young child.

## Key findings

- Adenosine administered intraosseously successfully converted SVT to normal sinus rhythm in a 3.5-year-old child.
- The successful conversion occurred after the second adenosine dose attempt.
- No recurrence of SVT was observed following treatment.

## Abstract

Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient’s condition, SVT treatment involves vagal manoeuvres, pharmacological, or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to a normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as the first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines, when vagal manoeuvres have proven ineffective. The ERC and AHA guidelines recommend the intravenous route of administration. The intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year-old child with SVT that was converted to NSR following IO administration of adenosine. Successful conversion was achieved after the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT.