title: Enlarged effects of adenosine in a septic patient with multiple myeloma and atrial flutter.
abstract: We report the history of a 60-year-old patient with a multiple myeloma and Staphylococcus aureus associated sepsis to whom adenosine in a dose of 6 mg was administered, when a regular, narrow QRS complex tachycardia at a heart rate of 120 beats/minute started. Adenosine led to a complete AV-block and revealed atrial flutter. Atrial flutter waves persisted for about 15 seconds and were followed by atrial and ventricular asystole for about 20 seconds. Repeated nonsustained polymorphic ventricular tachycardias followed and after about 90 seconds sinus rhythm was restored.
authors.affiliation: Department of Cardiology, Pneumology and Angiology, Medical Clinic and Policlinic B, Heinrich Heine University, Duesseldorf, Germany. stefan.dierkes@gmx.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Dierkes
authors.forename: Marcus G
authors.initials: MG
authors.lastname: Hennersdorf
authors.forename: Christian
authors.initials: C
authors.lastname: Perings
authors.forename: Bodo E
authors.initials: BE
authors.lastname: Strauer
mesh_terms: D000241:Adenosine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D004562:Electrocardiography; D017809:Fatal Outcome; D006327:Heart Block / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D009102:Multiple Organ Failure; D018805:Sepsis / Q000150:complications* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications*; D013610:Tachycardia / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000139:chemically induced
chemical_list: D000889:Anti-Arrhythmia Agents; D000241:Adenosine