title: Ventricular Fibrillation Precipitated by Intracoronary Adenosine During Fractional Flow Reserve Assessment - A Cautionary Tale.
abstract: Fractional flow reserve (FFR) measurement is the current benchmark for assessing the physiologic significance of a coronary stenosis. Intravenous / intra-coronary adenosine is a commonly used agent to induce hyperaemia, required for FFR measurement. In our institute, we have observed three cases of ventricular fibrillation (VF) after intra-coronary adenosine injection. Volume of the injections appeared to be the responsible mechanism, supported by evidence from optical coherence tomography (OCT) experience. Since doubling the concentration of adenosine to reduce the volume of injection by half, no further incidence of VF has been noted.
authors.affiliation: Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Ashish H
authors.initials: AH
authors.lastname: Shah
authors.affiliation: Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Chan
authors.affiliation: Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address: peter.seidelin@uhn.ca.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Seidelin
mesh_terms: D000241:Adenosine / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D053805:Fractional Flow Reserve, Myocardial / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D000241:Adenosine
keywords: Fractional flow reserve; Intra coronary adenosine; Ventricular fibrillation