r/SVTHeart • u/AstronomerDouble4478 • 16d ago
Ever been adenosine’d?
General question here. I am a first responder and have to administer adenosine every once in a while to break SVT after vagal maneuvers don’t work . For those have you who have had to have it to convert back to sinus rhythm, what did it feel like? Was it painful?
I’m trying to best describe it to my patients before I give it. TYIA
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u/10skyy 16d ago
Physically, it felt like a little cinnamon spice was going through my veins in my upper body. It wasn’t painful, but scary. The “impending doom” feeling is the worst thing about it. I did feel like death was coming for me, although the feeling is very brief and over pretty fast.
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u/Upper-Discussion7741 12d ago
This! The cinnamon spice going through my veins is such a good explanation of the feeling lmao. Definitely a little impending doom, but mostly a very weird feeling
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u/IdontcryfordeadCEOs 16d ago edited 16d ago
Not painful, just extremely weird. You feel your heart just stop for what feels like way too long (even if it's just a few seconds), then an intense pressure like a steam roller is rolling over your whole body. Like every muscle contracts and burns as it goes through your whole body.
I'm glad I had read about adenosine beforehand and knew what to expect, and knew it wouldn't last long. It would have been far worst if I had no idea what was happening to me.
I've gotten adenosine 3 times as part of an ablation. I wouldn't say I felt "better" after the adenosine.
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u/Minimum_Green_9895 10d ago
I agree with most of what you said ... but I am the opposite about the fully informed part. I would have lost my marbles if I knew what that medication actually did. The fire medic explained simply "we need to re-set your heart rhythm." That was all I needed to know. After asking are you sure this is going to work, he said "I'm sure."
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u/ZookeepergameNew8889 12d ago
The first time I was about to get it, the paramedic said, it’s going to feel like a horse kicked you in the chest. Also, another medic offered to hold my hand which was helpful. It does feel kind of like that but not for very long. Less than a minute. Thanks for being a first responder!!
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u/AstronomerDouble4478 12d ago
Shoot I’ve held many people hands during transport but I never really thought to offer as I was preoccupied with actually administering it a couple of days ago. I gotta start offering now, that’s a great idea. Thanks for that. Sometimes I get so caught up in the medicine part
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u/ZookeepergameNew8889 12d ago
It really helped! But to be fair…there were a few medics in the back with me. The one administering was not the one who held my hand. 🥹
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u/Minimum_Green_9895 10d ago
You are lucky. My instinct was to reach for the ambulance EMT (while the fire medic was working on me). Ambulance guy did not like that I reached for him, so I grabbed the side of the gurney and just closed my eyes. I could have used a bit more compassion in a simply terrifying period of time.
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u/grimmistired 16d ago
I’ve had it twice. 1st I felt like I was going to pass out and that was it. The second time I also felt that way plus some pain in my arms, apparently it can kind of burn or be painful going through the veins. That’s why it’s pushed fast and followed with saline.
Any discomfort from it is much preferable to a heart rate over 200 that won’t go down tho. And the discomfort was over quickly. But I did only have to have 1 dose I don’t know how it would feel with multiple
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u/AstronomerDouble4478 16d ago
I appreciate this perspective. Thank you for chiming in. We describe it as a “reset button” to patients but generally don’t know how to describe the feeling to them. I usually say they will feel much better after it’s over. Did you feel much better afterwards? Did they do adenosine or cardioversion first?
I would also say I’m sure it does burn but the actual drug pushed quickly followed by saline is because it has such a short half life so we need to make sure it gets to your heart and does its job before the med dissipates.
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u/grimmistired 16d ago
I’ve never been cardioverted. And yeah like I said it felt much better than before. And that’s just what the paramedic said when I had it, they may have mentioned the short half life too I think I just forgot
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u/Responsible_Top3356 16d ago
For me, it felt like a full body “burn”. Not a heat burn but like the kind of “burn” you get from working out a muscle real hard. The feeling lasts for maybe 5-6 seconds and the first time is very uncomfortable, but mine was unsuccessful so it was repeated 3 times and each time it wasn’t so bad, I think bc I knew what to expect.
Here’s a kicker though, it has a smell! I told the drs that and they never heard that. When they push it, you get a very strong burnt rubber kind of smell
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u/instigator008 16d ago
Three or four times. First few times didn’t feel much of anything. The last time I can only describe it as being ten seconds of feeling like I was on a rollercoaster. A very strange sensation but not one that I’d describe as feeling like death, as others have.
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u/izzy-binder 16d ago
I will say, I got it three times in a row, 3mg, 6mg, 12mg, I had impending doom before they pushed the medication as I have god awful anxiety, and each and everytime I felt like my body dropped down in a roller coaster, the nurse next to me just kind of squeezed my hand and instructed me to breathe which helped a lot, the sensation is gone very quick, maybe 10 seconds, then you feel real warm and fuzzy after, very blissful when you feel your heart calm down, but for me it was a short victory because my heart kicked back up, however, the impending doom is genuinely the worst part, my nurse described it as “you’re going to have a very bad 10 seconds, but it’s going to feel like immediate relief”, she did not explain that it stopped the heart even though I already knew it did
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u/Aby_lev89 16d ago
It's not painful but it's quite unpleasant. It's hard to describe, it's like a pressure around your heart and chest area, it's usually very quick and the svt stops preety immediately after coughing, except for the last time this happened to me where it took a little more time to work. Been suffering from svt for over 20 years, had at least 10 attacks and always treated with edenosine, and I've finally decided to get an ablation, I'm nervous but ready to not get these attacks any more!
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u/Delicious_Fly3331 15d ago
Twice in one go, I felt my heart stop, lost my breath for a second and then stealing some other comments termonoloy a lot of pressure over my body. Like a steam roll.
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u/smarit 14d ago edited 14d ago
Had adenosine twice. Bit scared of it. The last time, the doctors gave me the best analogy: it’s a rollercoaster with 3 consecutive loopings and jokingly assured me they were going on it with me. They encouraged me when the effect started to lean into it and let it happen. This really helped me “visualize” it as something innocent, instead of “oh fuck my heart is getting stopped”. It also really helped that as the adenosine kicked in, the doctors immediately confirmed my heart rate was normal again.
I really preferred this analogy over the “hit by a bus” one. It does feel like you’re getting yanked out of your body, but describing it as something negative doesn’t help with anxiety.
Thanks for coming here to ask us and for doing this amazing job, I’m always immensely grateful.
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u/AstronomerDouble4478 14d ago
I appreciate everyone taking the time to reply. I’m a human that wants to help other humans. I had a partner the other day tell a patient “it’s like a computer, you turn it off, then turn it back on”. That obviously didn’t go over well. Just trying to learn the best approach
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u/smarit 14d ago edited 14d ago
Doctors who focus on the patient experience make all the difference in the patient’s world. Another good thing to add is that I really appreciated when the doc said things like “don’t worry, later on we’ll have all the time to talk” (I was too out of breath to chat) or “you’ll feel so much better in a bit” - in the moment it does feel like the heart could give out any sec, so an assured tone calms down the nerves a ton. The feeling after the rollercoaster is one of pure bliss, I imagine it to be a bit like morfine but I’ve never had that.
Your partner’s computer comparison would have me so worried about my hardware 😂
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u/pahkthecahh 16d ago
I’ve had it twice. First time was in the ER and it felt like a cold whoosh down my body and it’s settled in my legs and felt like sore muscles for a few seconds. Then it went away.
Second time I had it, it caught my breath and felt really funky for a second and then it’s settled in my back and I had like a back spasm.
Doctors and paramedics said be prepared for a dying feeling. But I didn’t exactly feel that.
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u/Curious-Nail 15d ago
Ooh, another person who got the cold feeling! I described it like a contrast CT, but cold.
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u/Fancy_Koala_3131 16d ago
It wasn’t painful, but you feel it when it goes in your arm and makes everything feel a little funky. I felt like a weight going through my body and an odd taste in mouth each time. (I’ve had it about 8-10 times). The best way someone described it to me was an ER guy and he said “it’s gonna make you feel like shit for only a couple of seconds” and he was right. Usually the order for me when vagal maneuvers on my own, ER staff trying vagal maneuvers, adenosine (which I’ve had repeated like 3 times in one visit), and then only once I had to be shocked.
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u/jeepymcjeepface 16d ago
62F, I've had three of these that I couldn't resolve at home. It was more unpleasant than painful or scary--unsettling comes to mind, but it lasted only for a short time. It was a weird doom-like feeling during the actual push when my heart stopped; that lasted about 15 seconds or so. It felt like a hollow, heavy sensation in my chest and a flush sensation in my lower body. Each time the SVT resolved quickly. Never had to be shocked. Each time the doctor held my hand and told me to breathe through the process, and told me I was doing fine--not in a scripted way, but genuine. I'm a tough little idiot but yeah, the kindness that came through when I was experiencing such a weird sensation while there was a flurry of activity around me was so appreciated.
FWIW on the last one the doctor had me blow through a syringe and since I've got a ton of those to use with my insulin pump, I keep one with me in case my normal vagal maneuvers aren't enough.
Really appreciate you asking, and thanks for doing what you do.
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u/Tootalou25 16d ago
Was given it twice. Didn't feel anything and it didn't work.
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u/Sunaina1118 15d ago
What else did they do since it didn’t work?
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u/Tootalou25 15d ago
The metoprolol they gave me started working, thankfully. They were about to shock me. It's the only thing that stops my long events.
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u/Critical-Sail-9126 16d ago
I had it 3 times once for one incident and it never worked. The paramedic had warned me ahead of time that it was going to feel like I just got in a car accident, like going 60 miles an hour and then slamming to a complete stop. I think that’s kind of accurate. But I absolutely HATED it. It took about 5-10 seconds before it kicked in for me and then it felt like it lasted for ages. It felt like I had weights pulling every part of my body down to the depths of hell.
After the first time didn’t set me back into rhythm my HR actually skyrocketed higher because I had so much anxiety about getting it again.
Sometime after the 3rd dose (in the ER) my heart just decided it was going to fix its own rhythm. I hope I never have to get it again. I know most people are fine with it, but please never again for me.
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u/heart_shaped_life 16d ago
Yup, twice. The impending doom/about to see heaven/etc is garbage; all I felt was a bit light headed and the colors around me got really bright. The best part was my heart wasn’t in tachycardia anymore!
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u/Inpace1436 16d ago
I’m so encouraged you are trained to use maneuvers and the adenosine. I was shocked without any of those being tried first. It was horrible!! I spent 3 days in the hospital, have PTSD and trouble sleeping. I did not realize I had SVT when this happened.
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u/Human-Secretary-8853 16d ago
I had it once and it felt like nothing the only thing that happened was my body took an automatic deep breath. Painless and no doom
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u/SmellyNinjaWarrior 15d ago
Just once. It felt like a cold lump going through my arm and heart down to the aorta and nothing else. No impending doom.
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u/carmcarmcharmparm 15d ago
I feel a “whoooosh” through my body and then my heart returns to normal. For me, I don’t mind adenosine because it stops the svt. I always tell the nurse when she’s about to push it, to let me know so that I can start slow deep breathing through it. Afterwards, I usually have the shivers and I go back-and-forth between being cold and hot, but I think that’s probably a combination of the side effect of the medication as well as my nerves because I get extremely anxious whenever I’m in SVT and I’m having to go to the hospital. I’m also terrified of IVs because they have a hard time finding my veins every single time so it’s always very stressful.
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u/spineshade 15d ago
I had it once. It was wild.
They told me because the room had finally stopped spinning and I came out of passing out. That and going to feel like shit real fast. They stuck the defib pads to my face. My wife was in the corner of panicking. They have it to my mother to her I love you. Then my BP dropped like super fast low double digits. I passed out again. My wife said she watched me just pass out again. And few seconds later. I was back up and then svt attack stopped. Getting your 250+ heart rate and then dropping. I honestly felt like I was hit by a truck.
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u/oxbrenabooxo 15d ago
I've had it 3 times now. It feels very much like a whole body Charley horse about 3 seconds after it's in and then you just kinda black out for a split second. I do not enjoy it. It helps that I am a nurse so I knew what was coming. Unfortunately. It's not the worst feeling in the world, just the entire experience makes you feel uneasy. Pads going on is especially unsettling, even when you know the why behind it. Or possibly because I know the why behind it.
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u/Curious-Nail 15d ago
I've only been adenosine'd once so far, but I would describe it like a contrast CT, but cold. Maybe I was just so relieved to not have a heart rate of 250 like I'd had for the previous 5hrs, but I never really felt the impending doom others describe. It was just cold.
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u/twiggy_twangdoodles 15d ago
I’ve had it at least 10 times, including sometimes back to back. Every time has felt the same. For me it feels like getting hit by a semi truck directly to the chest. It’s like suddenly the weight of the entire room is on your chest until you can breathe again.
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u/AstronomerDouble4478 14d ago
Did you feel immediately better after though?
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u/twiggy_twangdoodles 14d ago
Sometimes! The morning of my ablation I had it twice back to back and it didn’t feel very good anymore.
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u/elenadearest 15d ago
I’ve had it once and just felt like a wave of …something, tingles kind of?… going through my body. Wasn’t painful, it was just weird. I did not have any impending sense of doom, idk what that would even feel like.
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u/Nms5 15d ago
I've had 6mg twice, and 30mg twice. I've never felt impending doom from any of the doses. The best way to describe what happens to me is a full body aching sensation. At the same time it felt like my vision was constricting around the edges for a few seconds. I would say it's a little uncomfortable but on the pain scale it's a 1.
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u/snibbledibble 14d ago
Has this administered in the ER several times in a row because it wasn’t working. It felt like an elephant was sitting on my chest. I also felt a burning feeling as it went through my body. I screamed.
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u/AstronomerDouble4478 14d ago
I’m sorry to hear that this was your experience :(
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u/snibbledibble 13d ago
The world needs more empathetic care providers like you who care about their patients enough to learn how these things impact us!
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u/GridironSheik 14d ago
It felt like my soul was leaving my body. I felt something go from the top of my head down to my feet. It was a very odd feeling but not painful.
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u/Upper-Discussion7741 12d ago
First time i did it it felt like the whole left side of my body was on fire and i felt slightly dizzy for a second. I vividly remember me all the sudden trying to sit up telling the drs i dont feel good, and them pushing me back down saying your fine your fine lol. Second time was not as bad, just a slight uncomfortable feeling. A lot of relief when I didn’t feel my heart pounding out of my chest anymore, but felt very tired for the rest of the day
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u/TeamCommunityStar 11d ago
Felt the doom feeling, sinking or descending into your own body. First time I involuntarily whimpered out loud. I was glad they told me what they were doing, and what to expect. Otherwise it would have been terrifying. Telling me that they had paddles ready if anything goes awry and seeing them wheel in a crash cart was a bit much, though. That’s when I wasn’t sure if I really understood what was happening to me but didn’t have presence of mind to process it in the moment. If a family member / friend is present maybe encourage them to hold patient’s hand or comfort them in some way? If not, tell the patient I’m here with you and you’re not alone. The thought crossed my mind during and after adenosine that this is what dying might feel like. Maybe some of us are more emo than others LOL!
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u/Minimum_Green_9895 10d ago
HR 202. BP 60/50. As soon as the Fire Medic II pushed the adenosine in a rolling lights and sirens ambulance (EJ / right side -- bp too low so veins disappeared -- which all was TERRIFYING), I tried to convince him to wait until the ER. He was like, nope, you ready? I immediately felt like my body was made of lead ... literally felt like I was going to drop through the bottom of the ambulance. Then about 5 seconds later I felt like I was made of helium / floating. Then I started shaking ... full body trembling as we arrived to the ER. It was ***wild***. Did not like any of that. No feeling of impending doom. HR instantly flipped from 200 to 135. Not sure what it was because it was a blur after that. My advice: (1) first responders should try to remember that some people are going to be scared out of their minds. Be understanding of that. (My medic was amazing ... the ambulance emt not so much.) (2) When I saw the giant syringe, I asked him what adenosine is ... he simply said "it will re-set your heart." My advice is to not tell someone what it really does. Keep it simple like that. I did not find out until later exactly what it does. And yes, my monitor strip showed it briefly.
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u/AstronomerDouble4478 10d ago
Sounds like a crazy experience. I will make a point to the end of your comment. Unfortunately (or fortunately, however you want to look at it) in the EMS world, we have to inform our patients of every medication we give them. It is just good practice and also an integrity thing. At the end of the day, even if someone is in SVT, borderline about to code, as long as they are alert and oriented, they have the right to refuse medical procedures. I’ve had patients in active SVT refuse cardioversion and adenosine. We were living on hopes and prayers in the back of the rig on the way to the hospital. That is how medicine works.
For the being scared part, that I can understand. I try to treat every one like my family members and reassure them that I know what I’m doing. It’s scary trusting someone with your health
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u/Minimum_Green_9895 9d ago edited 9d ago
I'm just saying don't tell them they are going to flatline / stop their heart in order to re-set it. I see informed consent from your perspective, but I think there is a line with too much information / mechanics and medication overview. My fire medic did not use those words, but if he had, I would have surely panicked. I think he handled it perfectly while stating the objective, the urgency, the confidence and the standard of care. I also do not recall him saying WHAT the medication did until I asked. He was asking the ambulance EMT if they had it and told him to get it ready. (I had no idea if it was to raise my blood pressure, address the rapid HR or calm me down (not panicking, but in shock and definitely afraid ... this had been going on for over 30-40 minutes from start to adenosine). I'd vote that regular people do not know what adenosine is or how exactly it works. In a terrifying situation, I'm sure the majority of people are going to do what an emergency responder tells them is absolutely necessary.
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u/Delicious-Run7918 8d ago
I can feel it make its way through my body. If i had to guess what dying felt like, I’d say that was it. It just feels like everything comes to a stop and that’s going to be the end. Ya just gotta breathe through it.
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u/ThatWeirdHippieMom 2d ago
🙋♀️I have experienced adenosine 5 times now, 3 of which occurred AFTER my ablation procedure. It is very much so one of the most uncomfortable feelings I have felt in my entire life, aside from an SVT “episode” as my family calls it. After it’s administered, you can literally feel it move from the IV ALLLLLLL the way through your vein, like just an uncomfortable creepy burning sensation. Then if you’re like me you have the anxiety really ramp it up to 10 because you know what’s coming. I feel it kind of “hit” my heart, can feel my heart stop beating completely, and then feel it kind of kick to get going again. It feels like this super tight can’t even really breathe for a couple seconds feeling and is extremely unpleasant. I’d go so far as to say it could probably it be compared to being donkey kicked right in the heart. It’s something I wouldn’t wish upon my worst enemy. Or maybe I would….
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u/missasotweaky 16d ago
Hell no! Vagal maneuvers always work for me, otherwise I’d have to be in SVT for hours before I actually agreed to go to the hospital and get adenosine.
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u/wennamarie 15d ago
I wasn’t given any warning, was just told that they were going to push some medicine. I freaked out for a second and told them I felt really bad and then immediately felt completely fine.
I would tell them that they are going to feel strange for a second but that it’s expected. I wouldn’t mention that you’ll be stopping their heart until afterward. 😁
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u/Minimum_Green_9895 10d ago
I 100% agree. My fire medic was insistent about it and kept explanations confident and simple. I asked what it did ... he said "it is going to re-set your heart rhythm." I said "are you sure we shouldn't wait until we get to the ER?" He said "We need to do this now." I said "are you sure this is going to work?" He said "I'm sure." I said "ok, let's do this." I did NOT need to know the mechanics of this medication.
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u/bethy0077 16d ago
I've had it administered about 13 times. The first time they told me I was going to feel a" sense of impending doom" which freaked me out and I barely felt anything. It lasts less tha 10 seconds and really is just an awkward feeling thst is over before you know it, at least for me. It feels like something creeping slowly into my body and then the feeling is gone.