Why the study?
Does adenosine administration precipitate polymorphic ventricular tachycardia in patients early after myocardial infarction?
Does adenosine administration precipitate polymorphic ventricular tachycardia in patients early after myocardial infarction?
Extra caution is warranted when using adenosine in the post-MI period due to the risk of precipitating hemodynamically unstable polymorphic ventricular tachycardia.
Adenosine may precipitate unstable polymorphic VT early post-MI; this case leaves open the arrhythmia risk and need for prospective evaluation.
An 86-year-old female developed supraventricular tachycardia 36 hours after a myocardial infarction (MI). She developed atrial fibrillation and polymorphic ventricular tachycardia (PVT) following administration of 12 mg of adenosine. The PVT caused hemodynamic instability with no response to cardioversion, but termination with procainamide. The heart is vulnerable to hemodynamically unstable, possibly lethal, PVT early after MI under some circumstances. This vulnerability may be exposed following administration of adenosine. Extra caution is warranted when using adenosine in the post-MI period.
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Kaplan et al. (2000) studied this question.
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