Document Detail


Variable effects of adenosine on retrograde conduction in patients with atrioventricular nodal reentry tachycardia.
MedLine Citation:
PMID:  9633068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adenosine has been demonstrated to reliably produce transient block of atrioventricular nodal (AVN) conduction, and has been advocated as a method of differentiating retrograde conduction via the atrioventricular node from accessory pathway conduction. However, the response of retrograde AVN to adenosine in patients with typical atrioventricular nodal reentry tachycardia (AVNRT) remains unclear. We evaluated 13 patients (mean age 45 +/- 20 years) with typical AVNRT prior to AVN modification. During right ventricular pacing, a rapid bolus of adenosine (0.2 mg/kg; maximum 18 mg) was administered. Adenosine sensitivity, defined by transient ventriculoatrial block, was observed in six patients, while in seven patients ventriculoatrial conduction was unaffected. An adenosine bolus administered during sinus rhythm or atrial pacing resulted in antegrade atrioventricular block in all the adenosine resistant patients in whom this was performed (n = 6). Comparisons of AVN electrophysiological characteristics between the adenosine sensitive and adenosine resistant patients were performed. There was no difference with respect to ventriculoatrial effective refractory period, ventriculoatrial Wenckebach, AVNRT cycle length, and His to atrial echo interval in AVNRT. However, there was a trend toward a longer antegrade fast pathway ERP in the adenosine sensitive group (P = 0.07). Electrophysiological properties do not predict retrograde AVN adenosine sensitivity. Adenosine does not cause retrograde AVN block in all patients with AVNRT, and therefore cannot reliably distinguish between retrograde conduction via the AVN or an accessory pathway.
Authors:
S B Fishberger; D Mehta; A F Rossi; M N Langan; S O Marx; J A Gomes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  21     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-08-26     Completed Date:  1998-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1254-7     Citation Subset:  IM    
Affiliation:
Division of Pediatric Cardiology, Mount Sinai Medical Center, New York 10029-6574, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use,  pharmacology*
Anti-Arrhythmia Agents / diagnostic use,  pharmacology*
Cardiac Pacing, Artificial
Female
Heart Block / chemically induced
Heart Conduction System / drug effects*,  physiopathology
Humans
Male
Middle Aged
Prospective Studies
Tachycardia, Atrioventricular Nodal Reentry / diagnosis,  physiopathology*
Chemical
Reg. No./Substance:
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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