The Drugs Used in the Treatment of Supraventricular Tachycardia in Pediatrics: A Systematic Review and Meta-Analysis

Background: Supraventricular tachycardia (SVT) is an abnormally rapid heart rhythm that results from improper electrical activity in the upper part of the heart. Acute management of children presenting with SVT may be a challenge, as the exact tachycardia mechanism is often unknown. The strategy for treatment depends on the presentation and clinical status of the patient. Methodology: A systematic literature review was conducted to identify and select original research reports on supraventricular tachycardia management drugs in children and infants with no structural heart disease (all children from 1 hour to 17 years of age) in accordance with the PRISMA guidelines. Data were analyzed with Review manager version 5.4. P-value and I2 were used to test the significance difference. Results: 26 studies out of 65 total studies assessed for eligibility were included in the review by fulfilling the inclusion criteria. There were 8103 patients from 13 countries with SVT who were treated with different antiarrhythmic drugs including (Adenosine, Dexmedetomidine) as acute management and (Amiodarone, Beta-Blockers, Flecainide, Digoxin and Ivabradine) as chronic control. There was a significant difference between the patients who took the drugs and the patients who responded to the drugs, with P-value <0.005 and I2 = 72%. Conclusion: There is not a first line treatment or second line treatment for SVT in pediatrics, and drug effectiveness can vary greatly between patients; all choices should be considered during the treatment protocol. The combination of drugs, as opposed to a single drug, is more efficient with less side effects in these patients. According to this review, the management of SVT in infants is highly dependent on the history of the patient and the probable side effects of some treatments that must be avoided.