Proarrhythmia in Patients with the Wolff-Parkinson-White Syndrome after Standard Doses of Intravenous Adenosine

Brief Communications1 March 1995Proarrhythmia in Patients with the Wolff-Parkinson-White Syndrome after Standard Doses of Intravenous AdenosineDerek V. Exner, MD, Timothy Muzyka, MD, and Anne M. Gillis, MDDerek V. Exner, MDFrom Foothills Hospital, Calgary, Alberta, Canada; and the Misericordia Hospital, Edmonton, Alberta, Canada., Timothy Muzyka, MDFrom Foothills Hospital, Calgary, Alberta, Canada; and the Misericordia Hospital, Edmonton, Alberta, Canada., and Anne M. Gillis, MDFrom Foothills Hospital, Calgary, Alberta, Canada; and the Misericordia Hospital, Edmonton, Alberta, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-5-199503010-00005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Adenosine, an endogenous nucleoside, has various effects on the heart and cardiovascular system [1]. Its actions on the heart's conduction system and its ability to terminate re-entrant supraventricular arrhythmias involving the atrioventricular node have been well described [1, 2]. The use of adenosine in the diagnosis and treatment of tachycardias that are not clearly of ventricular origin is now commonplace in many North American emergency departments. Adenosine is considered a safe diagnostic tool for distinguishing between regular wide-complex tachycardias (ventricular compared with aberrant supraventricular), including those seen in the setting of ventricular pre-excitation (the Wolff-Parkinson-White syndrome) [3].Electrophysiologic studies [3, ...References1. Belardinelli L, Linden J, Berne RM. The cardiac effects of adenosine. Prog Cardiovasc Dis. 1989; 32:73-97. Google Scholar2. Camm AJ, Garratt CJ. Adenosine and supraventricular tachycardia. N Engl J Med. 1991; 325:1621-9. Google Scholar3. Sharma AD, Klein GJ, Yee R. Intravenous adenosine triphosphate during wide QRS complex tachycardia: safety, therapeutic efficacy, and diagnostic utility. Am J Med. 1990; 88:337-43. Google Scholar4. Garratt CJ, Griffith MJ, O'Nunain S, Ward DE, Camm AJ. Effects of intravenous adenosine on antegrade refractoriness of accessory atrioventricular connections. Circulation. 1991; 84:1962-8. Google Scholar5. Brodsky MA, Allen B, Grimes JA, Gold C. Enhanced atrioventricular conduction during atrial flutter after intravenous adenosine (Letter). N Engl J Med. 1994; 330:288-9. Google Scholar6. Rankin AC, Rae AP, Houston A. Acceleration of ventricular response to atrial flutter after intravenous adenosine. Br Heart J. 1993; 69:263-5. Google Scholar7. Slade AK, Garratt CJ. Proarrhythmic effect of adenosine in a patient with atrial flutter. Br Heart J. 1993; 70:91-2. Google Scholar8. Botteron GW, Smith JM. Spatial and temporal inhomogeneity of adenosine's effect on atrial refractoriness in humans: using atrial fibrillation to probe atrial refractoriness. J Cardiovasc Electrophysiol. 1994; 5:477-84. Google Scholar9. Afridi I, Moise KJ Jr, Rokey R. Termination of supraventricular tachycardia with intravenous adenosine in a pregnant woman with Wolff-Parkinson-White syndrome. Obstet Gynecol. 1992; 80(3 pt 2):481-3. Google Scholar10. Manz M, Luderitz B. Supraventricular tachycardia and pre-excitation syndromes: pharmacologic therapy. Eur Heart J. 1993; 14(Suppl E):91-8. Google Scholar Author, Article, and Disclosure InformationAuthors: Derek V. Exner, MD; Timothy Muzyka, MD; Anne M. Gillis, MDAffiliations: From Foothills Hospital, Calgary, Alberta, Canada; and the Misericordia Hospital, Edmonton, Alberta, Canada.Corresponding Author: Anne M. Gillis, MD, Department of Medicine, Health Science Centre, University of Calgary, 3330 Hospital Drive Northwest, Calgary, Alberta, T2N 4N1 Canada.Grant Support: In part by the Heart and Stroke Foundation of Alberta, Canada. Dr. Gillis is a scholar of the Alberta Heritage Foundation for Medical Research. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug-Induced Atrial FibrillationProarrhythmia SyndromesCase 132Part 8: Adult Advanced Cardiovascular Life SupportPart 8: Advanced Life SupportPart 8: Advanced life supportSafety first — sedate and shockReplyRHYTHM DISORDERSAdenosine-Induced Ventricular Arrhythmias in Patients with Supraventricular TachycardiasDisorders of cardiac conductionAntiarrhythmic DrugsLife-Threatening Arrhythmias in the Intensive Care UnitUse of medications in Wolff-Parkinson-White syndromeElectrocardiographic manifestations: wide complex tachycardia due to accessory pathwayProarrhythmic Effects of Adenosine: One Decade of Clinical DataCARDIAC COMPLICATIONS IN THE INTENSIVE CARE UNITUse of adenosine in patients hospitalized in a university medical centerCLINICAL DIFFERENTIATION OF NARROW QRS COMPLEX TACHYCARDIASAtrioventricular Nodal Reentrant TachycardiaAdrenergic-dependent Effect of Adenosine-induced Ventricular Fibrillation in the Isolated Rabbit HeartAdenosine in the mammalian heart: nothing to get excited aboutAdenosine in the mammalian heart: nothing to get excited aboutManagement of paroxysmal atrioventricular nodal reentrant tachycardia in the critically ill surgical patientAdenosine in Wide-Complex TachycardiaExcitatory actions of adenosine on ventricular automaticityParoxysmal supraventricular tachycardiasAdenosineAcute therapy in patients with wide-QRS complex tachyarrhythmias 1 March 1995Volume 122, Issue 5 Page: 351-352 Keywords Adenosine Atrial fibrillation Electrocardiography Electrophysiological techniques Emergency department Heart Hemodynamics Syncope Tachycardia Ventricular fibrillation ePublished: 15 August 2000 Issue Published: 1 March 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. 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