Adenosine versus diltiazem for stopping SVT in the emergency department
COMparison of Adenosine Versus Diltiazem FOR Supraventricular Tachycardia in the ED (COMFORT-ED) - Pilot Trial
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 |
| Enrollment | 20 (estimated) |
| Ages | 18 Years to 100 Years |
| Sex | All |
| Sponsor | University of Iowa Academic / other |
| Locations | 1 site (Iowa City, Iowa) |
| Trial ID | NCT06993038 on ClinicalTrials.gov |
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.
Who should consider this trial
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.
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.
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 performed: 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.
Eligibility criteria
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 this trial is running
Iowa City, Iowa
- 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
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.