Adenosine-induced tachycardia acceleration: an unusual proarrhythmia.

Abstract

Adenosine is an effective agent for termination of most re-entrant supraventricular arrhythmias involving the atrioventricular node and often also used as a diagnostic agent for wide QRS tachycardias. Adenosine terminates 90-99% of re-entrant supraventricular tachycardias but it may rarely accelerate tachycardias. Adenosine-induced tachycardia acceleration is a rare phenomenon, as only a handful of cases have been described in the literature. We present a case of a 36-year-old man with a narrow complex, short RP tachycardia at a rate of 165 bpm and an initial blood pressure of 110/78 mm Hg. A bolus of 12 mg of adenosine resulted in slowing of the tachycardia to 150 bpm for 2-3 s, followed by acceleration of the tachycardia to 185 bpm that lasted for approximately 20 s and returned to baseline at 165 bpm. The main mechanism of adenosine-induced acceleration may be the secondary sympathetic stimulation, which may be preceded by transient bradycardia and/or hypotension.

• Authors: Vini Singh, Negar Salehi, Ranjan Kumar Thakur
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Jan 27 2015) ISSN: 1757-790X [Electronic] England
• PMID: 25628324 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Chemical References

• Anti-Arrhythmia Agents
• Adenosine

Topics

• Adenosine (adverse effects)
• Adult
• Anti-Arrhythmia Agents (adverse effects)
• Electrocardiography
• Heart Rate
• Humans
• Male
• Tachycardia, Atrioventricular Nodal Reentry (chemically induced)
• Tachycardia, Supraventricular (drug therapy)