Proarrhythmic effect of adenosine in a patient with atrial flutter.
Adenosine has been proposed as a useful diagnostic agent in patients with narrow complex regular tachycardia of uncertain origin. Its effects are usually transient owing to its extremely short plasma half life and, as a consequence, it is thought to be safer than other drugs used in the acute treatment of such arrhythmias. However, adenosine had a proarrhythmic effect when administered to a patient in order to confirm the diagnosis of atrial flutter. As expected, a transient increase in atrioventricular block was seen but this was followed by a doubling of the ventricular rate and haemodynamic compromise requiring immediate DC cardioversion. It is postulated that the secondary catecholamine-mediated effects of adenosine were responsible for this phenomenon.
Department of Cardiology, Royal Brompton National Heart and Lung Hospital, London.
A K
AK
Slade
C J
CJ
Garratt
D000241:Adenosine / Q000009:adverse effects* / Q000494:pharmacology; D000328:Adult; D001282:Atrial Flutter / Q000175:diagnosis* / Q000503:physiopathology; D004554:Electric Countershock; D004562:Electrocardiography; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008297:Male
D000241:Adenosine