Enhanced atrioventricular conduction during atrial flutter after intravenous adenosine
Open accessAbstract
To the Editor: Adenosine is the treatment of choice for tachycardia with narrow QRS complexes involving the atrioventricular node as part of its reentrant circuit1. It has also been recommended as a diagnostic aid in determining the mechanism of other tachyarrhythmias, but there has been no thorough analysis of its risks and benefits for this use. We report an adverse event associated with adenosine administered for diagnostic purposes to a patient with atrial flutter. A 53-year-old man came for medical evaluation because of palpitations. An electrophysiologic study previously revealed normal atrioventricular-node function (second-degree atrioventricular nodal Wenckebach block occurred at . . .
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Adenosine can produce a rebound increase of AV conduction to 1:1 and may precipitate AF.
“However, adenosine can produce a rebound increase of AV conduction to 1:1, and may also precipitate AF. 177,178”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [177]
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Cites
Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias
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Adenosine increases sympathetic nerve traffic in humans.
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Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome
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Acceleration of ventricular response to atrial flutter after intravenous adenosine.
Rankin, A. C., Rae, A. P., & Houston, A. B. (1993) · Heart · doi:10.1136/hrt.69.3.263 · Cited by 37 · see citing works
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Brugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomström‐Lundqvist, C., Calkins, H. G., Corrado, D., Deftereos, S. G., Diller, G., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz467 · Cited by 1,278 · see citing works
Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
Drew, B. J., & Scheinman, M. M. (1995) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1995.tb04647.x · Cited by 71 · see citing works
Life-threatening alterations in heart rate after the use of adenosine in atrial flutter
Brodsky, M. A., Hwang, C., Hunter, D., Chen, P., Smith, D. D., Ariani, M. K., Johnston, W. D., Allen, B. J., Chun, J. G., & Gold, C. R. (1995) · American Heart Journal · doi:10.1016/0002-8703(95)90367-4 · Cited by 36 · see citing works
Adenosine‐Induced Ventricular Arrhythmias in Patients with Supraventricular Tachycardias
Ertan, Ç., Atar, İ., Gülmez, Ö., Atar, A., Ozgül, A., Aydınalp, A., Müderrisoğlu, H., & Özin, B. (2008) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2008.00245.x · Cited by 22 · see citing works
Interstellar Meteoroids in the Japanese tv Catalogue
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Adenosine in Wide-Complex Tachycardia
Herbert, M., & Votey, S. R. (1997) · Annals of Emergency Medicine · doi:10.1016/s0196-0644(97)70324-x · Cited by 8 · see citing works
Cardiopulmonary Resuscitation: Basic and Advanced Life Support
McGlinch, B. P., & White, R. D. (2010) · Elsevier eBooks · doi:10.1016/b978-0-443-06959-8.00097-2 · Cited by 5 · see citing works
Cavotricuspid Isthmus-Dependent Atrial Flutter. Beyond Simple Linear Ablation
Lizarraga, J. A., Quesada-Ocete, J., Quesada-Ocete, B., Jiménez-Bello, J., & Quesada, A. (2024) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2501011 · Cited by 6 · see citing works
“In this regard, intravenous administration of adenosine can be helpful as it increases the degree of atrioventricular block, which enables better visualization of typical F waves on the surface electrocardiogram [38].”
BackgroundNon-sustained broad-complex tachycardia following intravenous adenosine.
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Unknown (1997) · Cardiovascular Research · doi:10.1016/s0008-6363(97)00082-5 · Cited by 1 · see citing works
What is going on with Adenosine?
Egea-Serrano, P. (2017) · Journal of Cardiology & Cardiovascular Therapy · doi:10.19080/jocct.2017.07.555712
“These effects lead to a higher conduction velocity through the AV node and they may also boost an increase in the ventricular automatism and so a ventricular tachycardia to appear (which also can degenerate to a torsades des pointes) [1-4].”
BackgroundKatritsis, D. G., & Morady, F. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-79338-4.00021-2
&NA; (1994) · Reactions Weekly · doi:10.2165/00128415-199404880-00007
- Authors
- Brodsky, M. A., Allen, B. J., Grimes, J. A., & Gold, C.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1994-01-27
- Volume
- 330
- Issue
- 4
- Pages
- 288-289
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2324567157
- Cited by
- 15
- References
- 5
- Citations by year
- 2024: 1 · 2021: 1 · 2019: 1 · 2017: 1 · 2016: 1
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- adenosine, atrial flutter, atrioventricular conduction, intravenous adenosine, adverse drug event, tachycardia mechanism, atrioventricular nodal reentrant tachycardia, Wenckebach block, electrophysiological study
- MeSH terms
- Adenosine, Atrial Flutter, Atrioventricular Node, Humans, Male, Middle Aged
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