Key result
Intravenous infusion of adenosine for fractional flow reserve assessment induced atrial fibrillation in a 68-year-old woman, which was successfully reversed by intravenous aminophylline.
Why the study?
Does intravenous adenosine induce atrial fibrillation during FFR assessment in a patient with suspected coronary artery disease?
Case Report (n=1)
Does intravenous adenosine induce atrial fibrillation during FFR assessment in a patient with suspected coronary artery disease?
Intravenous adenosine used for FFR assessment can rarely induce transient atrial fibrillation, which may require reversal with aminophylline and subsequent monitoring.
May warrant vigilance for transient AF during adenosine FFR; single case leaves open optimal reversal protocols.
A woman in her sixties presented with a history of progressive shortness of breath, palpitations, and feeling of chest heaviness for the last eight months. To rule out underlying obstructive coronary artery disease, an invasive cardiac catheterization was planned. To assess the hemodynamic significance of the lesion, resting full cycle ratio (RFR) and fractional flow reserve (FFR) values were measured. During this procedure, almost immediately after starting IV adenosine infusion, the patient went into atrial fibrillation which was reversed by IV aminophylline. Awareness of this uncommon effect of adenosine on the cardiac electrical pathways merits knowledge and a thorough follow-up testing of these patients is justified.
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Bhatheja et al. (2023) conducted a case report in Coronary artery disease (n=1). Adenosine was evaluated on Development of atrial fibrillation. Intravenous infusion of adenosine for fractional flow reserve assessment induced atrial fibrillation in a 68-year-old woman, which was successfully reversed by intravenous aminophylline.
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