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Asystole following regadenoson infusion in stable outpatients

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Journal of Nuclear Cardiology Aims and scope

Abstract

Regadenoson is a selective A2A receptor agonist approved for use as a pharmacologic stress agent for myocardial perfusion imaging after several multicenter trials demonstrated its equivalence in diagnostic accuracy for the detection of coronary artery disease and a decreased incidence of serious side effects as compared to adenosine. Recently, the FDA released a safety announcement advising of the rare but serious risk of heart attack and death associated with regadenoson and adenosine in cardiac stress testing, particularly in patients with unstable angina or cardiovascular instability. We report two cases of asystole with hemodynamic collapse in stable outpatients soon after receiving a standard regadenoson injection. The prevalence of potentially life threatening bradycardia, including asystole, associated with the use of regadenoson may be greater than previously expected. These cases highlight the need for cardiac stress labs to anticipate the potential for serious side effects with all patients during the administration of coronary vasodilators.

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Authors and Affiliations

  1. Maine Medical Center, Department of Cardiac Services, Tufts University School of Medicine, 22 Bramhall St, 119 Gannett Drive, Portland, ME, 04106, USA

    Jeffrey Rosenblatt MD, FACC, FASNC, Deirdre Mooney MD, MPH & Mylan Cohen MD, MPH, FACC, FASNC

  2. Maine Medical Partners Maine Health Cardiology, South Portland, ME, USA

    Jeffrey Rosenblatt MD, FACC, FASNC, Timothy Dunn CNMT, NMTCB & Mylan Cohen MD, MPH, FACC, FASNC

Authors
  1. Jeffrey Rosenblatt MD, FACC, FASNC
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  2. Deirdre Mooney MD, MPH
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  3. Timothy Dunn CNMT, NMTCB
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  4. Mylan Cohen MD, MPH, FACC, FASNC
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Corresponding author

Correspondence to Jeffrey Rosenblatt MD, FACC, FASNC.

Additional information

See related editorial, doi:10.1007/s12350-014-9922-4.

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Rosenblatt, J., Mooney, D., Dunn, T. et al. Asystole following regadenoson infusion in stable outpatients. J. Nucl. Cardiol. 21, 862–868 (2014). https://doi.org/10.1007/s12350-014-9898-0

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  • DOI: https://doi.org/10.1007/s12350-014-9898-0

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