| Limited dose-effect relationship of adenosine for detection of atrioventricular nodal duality in patients with supraventricular tachycardias. | |
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MedLine Citation:
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PMID: 17709920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of the study was to test the dose-effect relationship of adenosine for the diagnosis of dual atrioventricular (AV) nodal physiology in patients presenting with supraventricular tachycardia. SUBJECTS AND METHODS: The study population consisted of 57 patients (mean age 50 +/- 14 years; 36 females, 21 males) with palpitations related to supraventricular tachycardia. Adenosine was injected as bolus during sinus rhythm at rest in order to unmask dual AV nodal physiology by a PR jump on surface ECG (defined as a sudden increase by > or = 50 ms measured from the onset of the P-wave to the R-wave between two consecutive sinus beats). According to a stepwise clinical approach, adenosine was administered as bolus in incremental dosages (6 mg followed by 12 mg, if necessary up to 18 mg). Once a PR jump > or = 50 ms or a high-grade AV block was noted on surface ECG, the injection was stopped at that dose. RESULTS: A significant PR jump was noted after injection of 6 mg (n = 21, 99 +/- 30 ms) or 12 mg (n = 13, 94 +/- 35 ms), but not after 18 mg (n = 4, 35 +/- 10 ms) adenosine. Provocation of temporary first-grade AV block (n = 13) was associated with the longest increment of PR interval, whereas high-grade AV block (n = 36) produced a significantly shorter PR jump (105 +/- 35 vs. 65 +/- 40 ms, p = 0.0024). Electrophysiological study and ablation were performed in 37 highly symptomatic patients. AV nodal reentrant tachycardia was diagnosed in 33 patients and orthodromic AV reentrant tachycardia in 4 patients. CONCLUSION: The adenosine test was characterized by a reverse dose-effect relationship as far as identification of AV nodal duality was concerned. |
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Authors:
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Christiana Schernthaner; Maximilian Pichler; Bernhard Strohmer |
Publication Detail:
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Type: Journal Article; Validation Studies |
Journal Detail:
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Title: Medical principles and practice : international journal of the Kuwait University, Health Science Centre Volume: 16 ISSN: 1423-0151 ISO Abbreviation: Med Princ Pract Publication Date: 2007 |
Date Detail:
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Created Date: 2007-08-21 Completed Date: 2007-11-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8901334 Medline TA: Med Princ Pract Country: Switzerland |
Other Details:
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Languages: eng Pagination: 339-43 Citation Subset: IM |
Copyright Information:
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2007 S. Karger AG, Basel |
Affiliation:
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Department of Cardiology, Salzburger Landeskliniken, Paracelsus Private Medical University, Salzburg, Austria. c.schernthaner@salk.at |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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diagnostic use* Anti-Arrhythmia Agents / diagnostic use* Dose-Response Relationship, Drug Electrocardiography Female Humans Male Middle Aged Point-of-Care Systems Sensitivity and Specificity Tachycardia, Atrioventricular Nodal Reentry / diagnosis* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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