Key result
Adenosine infusion for nuclear stress testing induced sustained second-degree AV block requiring permanent pacemaker implantation in a 79-year-old man.
Case Report (n=1)
Adenosine infusion for nuclear stress testing can rarely cause sustained second-degree AV block requiring permanent pacemaker implantation, particularly in patients with underlying conduction system disease.
Alerts clinicians to rare adenosine-induced sustained AV block in elderly patients; leaves optimal pre-test conduction screening unresolved.
The agents used for nuclear stress testing (NST) including adenosine, dobutamine, and dipyridamole, are generally well tolerated and the incidence of serious complications associated with their use in NST is relatively low. Adenosine possesses a potent inhibitory effect on the atrioventricular (AV) node and may induce a transient conduction defect which could result in first-, second-, or third-degree heart block in some patients. The use of the potent AV nodal blocker adenosine for nuclear stress testing in patients with evidence of underlying conduction system disease may result in serious complications. We present the case of a 79-year-old man who had sustained second-degree AV block requiring permanent pacemaker implantation following adenosine infusion for nuclear stress testing. We also review the literature regarding the association between adenosine NST and AV block.
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Makaryus et al. (2008) conducted a case report in Atrioventricular block (n=1). Adenosine infusion was evaluated on Persistent second-degree AV block requiring permanent pacemaker implantation. Adenosine infusion for nuclear stress testing induced sustained second-degree AV block requiring permanent pacemaker implantation in a 79-year-old man.
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