Intravenous adenosine can paradoxically provoke orthodromic atrioventricular reentry tachycardia in patients with Wolff-Parkinson-White syndrome.
May warrant caution with adenosine in WPW; this case report leaves open prevalence and mechanisms of paradoxical AVRT.
Adenosine has been used to diagnose latent preexcitation in patients with the Wolff-Parkinson-White syndrome. A case is reported in which intermittent preexcitation had been previously observed, however only retrograde accessory pathway conduction was documented at the time of invasive electrophysiological study. Administration of intravenous adenosine during sinus rhythm resulted in provocation of orthodromic atrioventricular reentry tachycardia.
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Dougherty et al. (1993) studied this question.
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