Document Detail


Role of adenosine in the diagnosis and treatment of tachyarrhythmias in pediatric patients.
MedLine Citation:
PMID:  9363655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tachyarrhythmias are common rhythm disturbances in infants and children. Despite the availability of diagnostic criteria arrhythmias are sometimes commonly misdiagnosed. Recent reports suggest that an endogenous purine nucleoside, adenosine, has a diagnostic effect in narrow QRS complex tachycardias, in addition to terminating supraventricular tachycardia involving the atrioventricular node. This report reviews the authors' experience with the use of adenosine for diagnosis of narrow and wide complex tachyarrhythmias in children. Adenosine was administered to 43 patients with several types of tachyarrhythmias (mean age, 8.3 +/- 5.24 years). Nineteen patients had structural or acquired heart disease. Of the 43 patients there were 28 (65%) several different types of narrow QRS complex tachycardia and 14 (33%) ventricular arrhythmias. One patient (2%) had long QT. Adenosine terminated supraventricular tachycardia, in 11 of 12 patients (92%), ventricular tachycardia in five of eight patients (63%), and transiently terminated premature ventricular contractions in two of six patients (33%). The diagnostic ability of adenosine was perfect in eight supraventricular tachycardia. In these eight cases the tachycardia mechanism was unclear before the administration of adenosine, which demonstrated three cases of sinus tachycardia, three of atrial flutter, one of atrial fibrillation and one of atrial fibrilloflutter. Confirmation of the primary diagnosis by adenosine was perfect in five tachyarrhythmias including three cases of atrial flutter, one of atrial fibrillation and one of ectopic atrial tachycardia. The average effective dose of adenosine was 212 micrograms/kg (range, 100-400 micrograms/kg). There were no serious side-effects except transient dyspnea, chest pain and flushing. These findings demonstrate adenosine to be helpful and safe in the diagnosis of tachyarrhythmias.
Authors:
M Lenk; A Celiker; D Alehan; G Koçak; S Ozme
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica Japonica; Overseas edition     Volume:  39     ISSN:  0374-5600     ISO Abbreviation:  Acta Paediatr Jpn     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1998-01-07     Completed Date:  1998-01-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370357     Medline TA:  Acta Paediatr Jpn     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  570-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use*
Adolescent
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Tachycardia / diagnosis*,  physiopathology
Tachycardia, Sinoatrial Nodal Reentry / diagnosis
Tachycardia, Supraventricular / diagnosis
Tachycardia, Ventricular / diagnosis
Chemical
Reg. No./Substance:
58-61-7/Adenosine

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