Abstract
Adenosine provokes atrial fibrillation (AF) in some patients withparoxysmal supraventricular tachycardia (PSVT). Which patients are moresusceptible to develop atrial fibrillation after the administration ofadenosine to terminate PSVT is unknown. We prospectively measured atrialaction potential duration (APD) at incremental doses of 3, 6, and 12 mg ofadenosine at paced cycle lengths (CLs) of 600, 500, and 400 ms in 25patients. Bolus injection of adenosine decreased APD at 90%repolarization in a dose- and rate-dependent manner. During paced CLs of600, 500, and 400 ms, decreases of 8%, 13%, and 19% (p< 0.05), respectively, were found after bolus administration of 3 mg ofadenosine. After 6 mg of adenosine, the APD shortened by 12%, 19%, (p 0.05),and 27% (p < 0.01), respectively. After 12 mg of adenosine, the APDshortened by 15%, 27% (p < 0.05), and 38% (p < 0.01), respectively.Transient AF occurred in 4 of 25 (16%) patients, all during paced CLs of 400ms, and after adenosine 6 mg in one patient and 12 mg in three patients.Adenosine shortens atrial action potential duration in a dose- andrate-dependent manner. Whether patients with faster rates during PSVT andthose given higher doses of adenosine are more prone to develop atrialfibrillation remains to be determined.
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Tebbenjohanns, J., Malik, B., Pfeiffer, D. et al. Dose and Rate-Dependent Effects of Adenosine on Atrial Action Potential Duration in Humans. J Interv Card Electrophysiol 1, 33–37 (1997). https://doi.org/10.1023/A:1009758501195
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DOI: https://doi.org/10.1023/A:1009758501195