Key result
Intravenous adenosine administration in a patient with class IC atrial flutter resulted in adequate slowing of the ventricular rate and normalization of QRS complexes.
Case Report (n=1)
No
Adenosine is a useful diagnostic agent for differentiating wide QRS complex tachycardia, specifically revealing class IC atrial flutter with aberrant conduction in patients on flecainide.
May aid diagnosis of flecainide-induced wide QRS flutter; leaves open need for prospective validation before broader use.
We report the case of a 67-year-old female with a wide QRS complex tachycardia at 180 bpm. A diagnosis of class IC atrial flutter with aberrant ventricular conduction caused by flecainide therapy was formulated. Intravenous adenosine administration resulted in adequate slowing of the ventricular rate and normalization of QRS complexes. Restoration of sinus rhythm was achieved with intravenous amiodarone. The response to adenosine confirmed the diagnosis of supraventricular tachycardia with aberrant conduction, but the transition from arrhythmia onset to restoration of sinus rhythm showed interesting peculiarities.
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Rotondi et al. (2015) conducted a case report in Class IC atrial flutter (n=1). Adenosine was evaluated on Ventricular rate and QRS complex normalization. Intravenous adenosine administration in a patient with class IC atrial flutter resulted in adequate slowing of the ventricular rate and normalization of QRS complexes.
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