Adenosine-related Ventricular Asystole

Letters15 February 1993Adenosine-related Ventricular AsystolePatrick L. McCollam, MD, Walter E. Uber, MD, and Adrian B. Van Bakel, MDPatrick L. McCollam, MDSearch for more papers by this author, Walter E. Uber, MDSearch for more papers by this author, and Adrian B. Van Bakel, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-4-199302150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Currently, no published guidelines address the administration of adenosine by central venous access [1]. We describe three patients who received 3 or 6 mg (0.035 to 0.097 mg/kg) of adenosine and experienced heart block or ventricular asystole lasting from 3 to 21 seconds (see Table 1 below). A fourth exhibited no adverse effects after 3 mg (0.033 mg/kg) of adenosine. All were patients in intensive care who received adenosine diagnostically. None had known conduction abnormalities. Two were heart transplant recipients experiencing severe rejection.Table 1. Patient Characteristics* Potential drug interactions with adenosine may ...References1. Faulds D, Chrisp P, Buckley MM. Adenosine. An evaluation of its use in cardiac diagnostic procedures, and in the treatment of paroxysmal supraventricular tachycardia. Drugs. 1991; 41:596-624. Google Scholar2. Pelleg A, Porter S. The pharmacology of adenosine. Pharmacotherapy. 1990; 10:157-74. Google Scholar3. Watt AH, Bernard MS, Webster J, Passani SL, Stephens MR, Routledge PA. Intravenous adenosine in the treatment of supraventricular tachycardia: a dose-ranging study and interaction with dipyridamole. Br J Clin Pharmacol. 1986; 21:227-30. Google Scholar4. Ellenbogen KA, Thames MD, DiMarco JP, Sheehan H, Lerman BB. Electrophysiological effects of adenosine in the transplanted human heart: evidence of supersensitivity. Circulation. 1990; 81:821-8. Google Scholar5. Sellers TD, Kirchhoffer JB, Modesto TA. Adenosine: a clinical experience and comparison with verapamil for the termination of supraventricular tachycardias. In: Pelleg A, Michelson EL, Driefus LS; eds. Cardiac Electrophysiology and Pharmacology of Adenosine and ATP. New York: Liss; 1987:283-99. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByUnmasking Adenosine: The Purinergic Signalling Molecule Critical to Arrhythmia Pathophysiology and ManagementTachyarrhythmienProarrhythmic Effects of Adenosine: One Decade of Clinical DataLife-threatening alterations in heart rate after the use of adenosine in atrial flutterIs adenosine really safe? 15 February 1993Volume 118, Issue 4Page: 315-316KeywordsAdenosineAdverse reactionsDrug interactionsDrugsEffective doseHeartPatientsTachycardiaTransplantation Issue Published: 15 February 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...