Adenosine administration during preexcited atrial fibrillation induced ventricular fibrillation in patients with accessory pathways having short refractory periods (antegrade AP ERP 227 vs 289 ms).
Case-Control (n=9)
Does adenosine administration during preexcited atrial fibrillation induce ventricular fibrillation in patients with Wolff-Parkinson-White syndrome?
Adenosine administration during preexcited atrial fibrillation can induce ventricular fibrillation, especially in patients with short accessory pathway refractory periods.
Absolute Event Rate: 227% vs 289%
p-value: p=<0.05
GUPTA, A. K., et al. : Adenosine Induced Ventricular Fibrillation in Wolff‐Parkinson‐White Syndrome. VF was observed in four patients (group A) with preexcited AF presenting to the emergency department who had been given 12 mg of adenosine. These patients were resuscitated and underwent electrophysiological study and catheter ablation of the accessory pathway (AP). In a control (group B) of five patients with manifest AP, sustained AF was induced by rapid atrial pacing during electrophysiological study and 12 mg of adenosine was administered. The ECG and electrophysiologic features in the two groups were compared. All patients had a single manifest AP. In group A, three patients had a left free‐wall AP and one patient had a posteroseptal AP, while in the control group all had left free‐wall APs. The antegrade AP effective refractory period (ERP) in groups A and B was 227 ± 29 and 289 ± 37 ms , respectively ( P 0.05 ). The shortest R‐R interval during AF in group A was 246 ± 51 ms and 301 ± 60 ms in group B ( P value < 0.05 ). After adenosine, no patient in group B developed VF. Adenosine may cause VF when administered during preexcited AF. This phenomenon is seen in patients having APs with short refractory periods.
Gupta et al. (Mon,) conducted a case-control in Wolff-Parkinson-White Syndrome with preexcited atrial fibrillation (n=9). Adenosine vs. Control patients with manifest AP and induced sustained AF was evaluated on Antegrade AP effective refractory period (ERP) in milliseconds (p=<0.05). Adenosine administration during preexcited atrial fibrillation induced ventricular fibrillation in patients with accessory pathways having short refractory periods (antegrade AP ERP 227 vs 289 ms).