Electrophysiologic effects of adenosine triphosphate and adenosine on the mammalian heart: Clinical and experimental aspects

Adenosine triphosphate (ATP) and adenosine have strong negative chronotropic and dromotropic effects on the mammalian heart. The sensitivity of the sinus node and the atrioventricular node to ATP and adenosine manifests pronounced variability among species. For more than three decades, ATP has been used routinely in Europe in the acute therapy of paroxysmal supraventricular tachycardia. Preliminary clinical trials with adenosine in the United States suggest that this compound may have a similar therapeutic value. The exact mechanisms of action of ATP and adenosine on the mammalian heart are still not fully known. However, the vast clinical experience indicates that ATP, and probably also adenosine, can be safely and repetitively used in the acute therapy of paroxysmal supraventricular tachycardia.