Adenosine as an antiarrhythmic agent.
Adenosine produces acute inhibition of sinus node and atrioventricular (AV) nodal function. This profound but short lived electrophysiologic effect makes adenosine a suitable agent for treating supraventricular tachycardias (SVT) that incorporate the sinus node or AV node as part of the arrhythmia circuit, or for unmasking atrial tachyarrhythmias or ventricular pre-excitation. Its antiadrenergic properties also make it an effective agent for use with some unique atrial and ventricular tachycardias. Appropriate dosing and rapid bolusing with intravenous administration is required. Recognition of infrequent proarrhythmic risks and potential drug interactions with xanthine derivatives and dipyridamole should maximize its safe and effective use. This review will highlight adenosine's mechanism of action, administration, clinical indications, efficacy, and risks when used in tachyarrhythmic management.
Wilbur
S L
SL
Department of Medicine, Allegheny University of the Health Sciences, Philadelphia, Pennsylvania 19102, USA.
Marchlinski
F E
FE
D000241:Adenosine / Q000008:administration & dosage / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000188:drug therapy; D014927:Wolff-Parkinson-White Syndrome / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D000241:Adenosine