gms | German Medical Science

33. Internationale Konferenz für Elektrokardiographie

Internationale Konferenz für Elektrokardiographie

Adenosine Induced Ventricular Arrhythmias In Patients With Supraventricular Tachycardias

Meeting Abstract

  • corresponding author presenting/speaker I. Atar - Baskent University, Ankara, Türkei
  • C. Ertan - Baskent University, Ankara, Türkei
  • A. Ozgul - Baskent University, Ankara, Türkei
  • O. Gulmez - Baskent University, Ankara, Türkei
  • A. Atar - Baskent University, Ankara, Türkei
  • S. Balta - Baskent University, Ankara, Türkei
  • K. Demirtas - Baskent University, Ankara, Türkei
  • H. Muderrisoglu - Baskent University, Ankara, Türkei
  • B. Ozin - Baskent University, Ankara, Türkei

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice092

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/ice2006/06ice092.shtml

Veröffentlicht: 8. Februar 2007

© 2007 Atar et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Purpose: Adenosine is a purine nucleoside analogue with a short half life. It is the first choice of drug for the termination of supraventricular arrhythmias where the atrioventricular node forms one arm of the reentry cycle. Previously some case reports, and a few retrospective study reported proarrhythmias after adenosine administration however, the prevalence and characteristics of adenosine induced proarrhytmia are largely unknown. Thus, we retrospectively studied all cases of adenosine use for tachycardia management in our center over a period of 9 years to asses the proarrhytmic potential of adenosine.

Methods: The records of all patients, who received adenosine at Baskent University Ankara Hospital for the management of supraventricular tachycardia were retrospectively studied. Among these patients, those with a continous ECG recording during adenosine administration were identified. By means of this review, 52 tachycardia episodes of 46 patients were identified. Demographic properties, classification of tachycardia, details of electrophysiologic study if performed, concomitant diseases, heart rate, echocardiographic findings, adenosine dose, ventricular arrhythmias and response to treatment were recorded.

Results: Of 52 tachycardia episodes in 46 patients, 28 (%53.8) episodes occurred in 23 (%50) women. 41 patients had 1,4 patients had 2 and 1 patient had 3 episodes for which adenosine was administered and continuous ECG recording was taken.Patients presented with an average tachycardia rate of 174 ± 20 beats/min (range between 133 – 214 beats/min). Average adenosine dose administered was 11.0±4.6 mg (range between 6 – 24 mg). Electrophysiologic study was performed in 22 of patients and 17 of these patients were diagnosed as atrio-ventricular nodal reentrant tachycardia (AVNRT). Following adenosine administration,ventricular extrasystoles or ventricular tachycardia developed in 22(%47.8) patients and in 26(%50) tachycardia episodes. Of these ventricular extrasystoles,9 had monomorphic,17 had polymorphic ventricular extrasystoles.Patients had a mean of 5.2 ± 3.7 ventricular extrasystoles (range between 1 – 14 beats). No patients had a sustained ventricular tachycardia. Non-sustained ventricular tachycardia developed in 8(%17.4) patients. All ventricular tachycardia episodes were polymorphic, short and self terminating (mean duration 5.6 ± 3.7 beats, range 3-14 beats) with an avarage rate of 198 ± 46 beats/min (range between 136 – 272 beats/min). Demographic characteristics, concomitant systemic diseases, drug usage, mean tachycardia rate, mean adenosine dose and basal QTc distance was not statistically different in patients with and without ventricular arrhythmias after adenosine administration.

Discussion: This study demonstrates that ventricular extrasystoles or non sustained ventricular tachycardia may develop following adenosine administration however the risk of life threatening ventricular arrhythmias is not increased.