Rithvik Talluri - Department of Cardiology
Paroxysmal superventricular tachycardia (PSVT) has become an increasingly costly medical issue globally. 30,000 people are diagnosed in the US yearly with this symptom, resulting in accelerated heart rate, chest pain, shortness of breath, palpitations, and dizziness. 25% of these episodes are followed by hospital admissions. New developments are crucial such as the ones explored in the RAPID clinical trial (NCT03464019). In this trial, researchers prescribed etripamil, a fast-acting calcium-channel blocker, in the form of a nasal spray for people to use when they are having a PSVT episode. This medication would allow the patient to return to a normal heart rhythm at home at a much faster rate than current oral medications without a medical professional.
The RAPID trial found a significant difference between patients who used intranasal etripamil versus those who had used a placebo with 64% of the experimental group returning to a normal heart rate within 30 minutes versus 31% of the control group. Further, they found that people on the medication recovered on average within 17 minutes while patients who took the placebo took an average of 53 minutes. The patients also took a survey afterwards which showed that other symptoms of PSVT were more effectively relieved in the experimental group. However, the study was unable to conclude that the medication would reduce hospitalization rates. These results are promising for the future of etripamil as a quick at-home treatment for PSVT but it cannot be a substitute for medical care during more severe episodes.
References:
Stambler, Bruce S, et al. “Self-administered intranasal etripamil using a symptom-prompted, repeat-dose regimen for atrioventricular-nodal-dependent supraventricular tachycardia (rapid): A multicentre, randomised trial.” The Lancet, vol. 402, no. 10396, 15 June 2023, pp. 118–128, https://doi.org/10.1016/s0140-6736(23)00776-6.
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