Abstract
Adenosine may be of therapeutic and diagnostic value in the emergency management of arrhythmias. It causes transient atrioventricular nodal block and thus ends paroxysmal supraventricular tachycardias that involve the atrioventricular node. Also, it may uncover underlying atrial arrhythmias by slowing the ventricular response. Its duration of action is brief and serious adverse effects have not been reported. A 12 year old patient with atrial flutter is presented, in whom intravenous adenosine was followed by acceleration of the heart rate to a potentially dangerous arrhythmia.
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- Biaggioni I., Killian T. J., Mosqueda-Garcia R., Robertson R. M., Robertson D. Adenosine increases sympathetic nerve traffic in humans. Circulation. 1991 May;83(5):1668–1675. doi: 10.1161/01.cir.83.5.1668. [DOI] [PubMed] [Google Scholar]
- Biaggioni I., Olafsson B., Robertson R. M., Hollister A. S., Robertson D. Cardiovascular and respiratory effects of adenosine in conscious man. Evidence for chemoreceptor activation. Circ Res. 1987 Dec;61(6):779–786. doi: 10.1161/01.res.61.6.779. [DOI] [PubMed] [Google Scholar]
- DiMarco J. P., Miles W., Akhtar M., Milstein S., Sharma A. D., Platia E., McGovern B., Scheinman M. M., Govier W. C. Adenosine for paroxysmal supraventricular tachycardia: dose ranging and comparison with verapamil. Assessment in placebo-controlled, multicenter trials. The Adenosine for PSVT Study Group. Ann Intern Med. 1990 Jul 15;113(2):104–110. doi: 10.7326/0003-4819-113-2-104. [DOI] [PubMed] [Google Scholar]
- DiMarco J. P., Sellers T. D., Berne R. M., West G. A., Belardinelli L. Adenosine: electrophysiologic effects and therapeutic use for terminating paroxysmal supraventricular tachycardia. Circulation. 1983 Dec;68(6):1254–1263. doi: 10.1161/01.cir.68.6.1254. [DOI] [PubMed] [Google Scholar]
- Favale S., Di Biase M., Rizzo U., Belardinelli L., Rizzon P. Effect of adenosine and adenosine-5'-triphosphate on atrioventricular conduction in patients. J Am Coll Cardiol. 1985 May;5(5):1212–1219. doi: 10.1016/s0735-1097(85)80027-9. [DOI] [PubMed] [Google Scholar]
- Flinn C. J., Wolff G. S., Dick M., 2nd, Campbell R. M., Borkat G., Casta A., Hordof A., Hougen T. J., Kavey R. E., Kugler J. Cardiac rhythm after the Mustard operation for complete transposition of the great arteries. N Engl J Med. 1984 Jun 21;310(25):1635–1638. doi: 10.1056/NEJM198406213102504. [DOI] [PubMed] [Google Scholar]
- Garratt C. J., Griffith M. J., O'Nunain S., Ward D. E., Camm A. J. Effects of intravenous adenosine on antegrade refractoriness of accessory atrioventricular connections. Circulation. 1991 Nov;84(5):1962–1968. doi: 10.1161/01.cir.84.5.1962. [DOI] [PubMed] [Google Scholar]
- Garson A., Jr, Bink-Boelkens M., Hesslein P. S., Hordof A. J., Keane J. F., Neches W. H., Porter C. J. Atrial flutter in the young: a collaborative study of 380 cases. J Am Coll Cardiol. 1985 Oct;6(4):871–878. doi: 10.1016/s0735-1097(85)80497-6. [DOI] [PubMed] [Google Scholar]
- Griffith M. J., Linker N. J., Ward D. E., Camm A. J. Adenosine in the diagnosis of broad complex tachycardia. Lancet. 1988 Mar 26;1(8587):672–675. doi: 10.1016/s0140-6736(88)91476-6. [DOI] [PubMed] [Google Scholar]
- Möser G. H., Schrader J., Deussen A. Turnover of adenosine in plasma of human and dog blood. Am J Physiol. 1989 Apr;256(4 Pt 1):C799–C806. doi: 10.1152/ajpcell.1989.256.4.C799. [DOI] [PubMed] [Google Scholar]
- Rankin A. C., Oldroyd K. G., Chong E., Rae A. P., Cobbe S. M. Value and limitations of adenosine in the diagnosis and treatment of narrow and broad complex tachycardias. Br Heart J. 1989 Sep;62(3):195–203. doi: 10.1136/hrt.62.3.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Silka M. J., Kron J., Walance C. G., Cutler J. E., McAnulty J. H. Assessment and follow-up of pediatric survivors of sudden cardiac death. Circulation. 1990 Aug;82(2):341–349. doi: 10.1161/01.cir.82.2.341. [DOI] [PubMed] [Google Scholar]
- Till J., Shinebourne E. A., Rigby M. L., Clarke B., Ward D. E., Rowland E. Efficacy and safety of adenosine in the treatment of supraventricular tachycardia in infants and children. Br Heart J. 1989 Sep;62(3):204–211. doi: 10.1136/hrt.62.3.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watt A. H., Routledge P. A. Transient bradycardia and subsequent sinus tachycardia produced by intravenous adenosine in healthy adult subjects. Br J Clin Pharmacol. 1986 May;21(5):533–536. doi: 10.1111/j.1365-2125.1986.tb02838.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- diMarco J. P., Sellers T. D., Lerman B. B., Greenberg M. L., Berne R. M., Belardinelli L. Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias. J Am Coll Cardiol. 1985 Aug;6(2):417–425. doi: 10.1016/s0735-1097(85)80181-9. [DOI] [PubMed] [Google Scholar]