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Variable Effects of Adenosine on Retrograde Conduction in Patients with Atrioventricular Nodal Reentry Tachycardia
- Source :
- Pacing and Clinical Electrophysiology. 21:1254-1257
- Publication Year :
- 1998
- Publisher :
- Wiley, 1998.
-
Abstract
- 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.
- Subjects :
- Male
Tachycardia
medicine.medical_specialty
Adenosine
Accessory pathway
Bolus (medicine)
Heart Conduction System
Internal medicine
medicine
Humans
Tachycardia, Atrioventricular Nodal Reentry
Sinus rhythm
Prospective Studies
business.industry
Cardiac Pacing, Artificial
Effective refractory period
General Medicine
Middle Aged
medicine.disease
Atrioventricular node
Heart Block
medicine.anatomical_structure
Anesthesia
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Anti-Arrhythmia Agents
Atrioventricular block
medicine.drug
Subjects
Details
- ISSN :
- 15408159 and 01478389
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Pacing and Clinical Electrophysiology
- Accession number :
- edsair.doi.dedup.....9d4da515cc8188f06cf78c14a1cfa4ca