title: Adenosine and Preexcitation Variants: Reappraisal of Electrocardiographic Changes.
abstract: Intravenous adenosine is a short-acting blocker of the atrioventricular node that has been used to unmask subtle or latent preexcitation, and also to enable catheter ablation in selected patients with absent or intermittent preexcitation. Depending on the accessory pathway characteristics, intravenous adenosine may produce specific electrocardiographic changes highly suggestive of the preexcitation variant. Herein, we view different ECG responses to this pharmacological test in various preexcitation patterns that were confirmed by electrophysiological studies. Careful analysis of electrocardiographic changes during adenosine test, with emphasis on P-delta interval, preexcitation degree, and atrioventricular block, can be helpful to diagnose the preexcitation variant/pattern.
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Hussam
authors.initials: H
authors.lastname: Ali
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Lupo
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Foresti
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: De Ambroggi
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Epicoco
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Lombardy, Italy.
authors.forename: Angelica
authors.initials: A
authors.lastname: Fundaliotis
authors.affiliation: Arrhythmia and Electrophysiology Research Center, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cappato
mesh_terms: D000241:Adenosine / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D017115:Catheter Ablation; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D011226:Pre-Excitation Syndromes / Q000188:drug therapy* / Q000503:physiopathology*; D014927:Wolff-Parkinson-White Syndrome / Q000188:drug therapy* / Q000503:physiopathology* / Q000601:surgery
chemical_list: D000889:Anti-Arrhythmia Agents; D000241:Adenosine
keywords: accessory pathway; adenosine; preexcitation variants