Adenosine versus diltiazem for stopping SVT in the emergency department
Official title: COMparison of Adenosine Versus Diltiazem FOR Supraventricular Tachycardia in the ED (COMFORT-ED) - Pilot Trial
Run by University of Iowa · NCT06993038 · Data updated 2026-11-12
This pilot will try two IV medicines—adenosine and diltiazem—in adults with acute, stable SVT in the Emergency Department to learn which treatment patients prefer and how they feel afterward.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years to 100 Years |
| Sex | All |
| Enrollment | 20 (estimated) |
| Sponsor | University of Iowa Academic / other |
| Locations | 1 site (Iowa City, Iowa) |
| Status | Recruiting |
| Started | August 1, 2025 |
| Main results expected | July 2027 |
| Study ends | December 2027 |
| Registry record updated | May 28, 2026 |
| Trial ID | NCT06993038 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18 years) presenting to the ED with acute, stable SVT who have not already received IV AV-nodal blocking medications and who do not have WPW, reduced LVEF ≤40%, severe bronchoconstrictive lung disease, pregnancy, or incarceration.
✕Probably not a fit
Patients with unstable SVT, prior IV AV-nodal blocker use before enrollment, known WPW, significant systolic heart failure, severe reactive airways disease, pregnancy, or those who are incarcerated are unlikely to be eligible or to benefit from this pilot.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This single-center, phase 4 pilot compares patient perceptions of intravenous adenosine and diltiazem when used to treat acute, stable supraventricular tachycardia in adults presenting to the Emergency Department. Adult patients who have not already received IV AV-nodal blocking agents and who do not have exclusion conditions (for example, WPW, reduced LVEF ≤40%, severe bronchoconstrictive lung disease, pregnancy, or incarceration) can be enrolled. The primary focus is on patient-reported experiences and tolerability after medication administration rather than on large clinical endpoints. Findings will inform patient-centered choices about SVT treatment and help plan larger comparative studies.
Why it matters
Potential benefit: If successful, the findings could help clinicians choose the SVT medication that patients tolerate and prefer, improving patient comfort and shared decision-making in the ED.
How similar studies have gone: Both adenosine and diltiazem are established treatments that effectively terminate or control SVT, but direct comparisons focusing on patient-reported tolerability and preference are limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Adult patients (18 years and older) 2. Diagnosis of acute, stable SVT in the emergency department Exclusion Criteria: 1. Receipt of IV AV-nodal blocking agents prior to study enrollment (includes adenosine, non-dihydropyridine calcium channel blockers, beta-antagonists in pre-hospital and/or hospital setting). 2. Reported or confirmed personal history of Wolff-Parkinson-White (WPW) syndrome 3. History of heart failure with reduce ejection fraction (HFrEF) (LVEF\</= 40%) 4. Severe bronchoconstrictive lung disease 5. Prior hypersensitivity to study medication 6. Previously enrolled in pilot study 7. Pregnant 8. Incarcerated
Where it's running
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University of Iowa Health Care
Iowa City, Iowa, United States Recruiting
Study contacts
- Principal investigator: Anne Zepeski, PharmD — University of Iowa
- Study coordinator: Anne Zepeski, PharmD
- Email: anne-zepeski@uiowa.edu
- Phone: (319) 356-2577
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
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Diltiazem versus adenosine for treating supraventricular tachycardia in the emergency room
This study will see if IV diltiazem or IV adenosine works better and causes fewer side effects for adults who come to the emergency department with supraventricular tachycardia.
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.