Failure of adenosine to terminate focal atrial tachycardia
Tóm tắt
Adenosine has proven effectiveness in the diagnosis and treatment of a variety of tachycardias with both normal and widened QRS complexes in children and adults. Its effectiveness is due to its depressant effects on atrioventricular node conduction. Adenosine might also be effective against automatic tachycardia due to spontaneous activation in partially depolarized cells. This report describes a patient presenting with tachycardia with normal QRS complexes. While the adenosine did not restore sinus rhythm, it did disclose the mechanism of the arrhythmia. Since other investigators have reported successful interruption of automatic atrial tachycardia, this case suggests that automatic atrial tachyarrhythmia may be due to more than one mechanism.
Tài liệu tham khảo
Belardinelli L, Isenberg G (1983) Isolated atrial myocytes: adenosine and acetylcholine increase potassium conductance.Am J Physiol 244:H734-H737
DiMarco JP, Sellers TD, Lerman BB, Greenberg ML, Berne RM, Belardinelli L (1985) Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias.JACC 6:417–425
Overholt ED, Rheuban KS, Gutgesell HP, Lerman BB, Di-Marco JP (1988) Usefulness of adenosine for arrhythmias in infants and children.Am J Cardiol 61:336–340
Perelman MS, Krikler DM (1987) Termination of focal atrial tachycardia by adenosine triphosphate.Br Heart J 58:528–530
Rankin AC, Oldroyd KG, Chong E, Rae AP, Cobbe SM (1989) Value and limitations of adenosine in the diagnosis and treatment of narrow and broad complex tachycardias.Br Heart J 62:195–203
Till J, Shinebourne EA, Rigby ML, Clarke B, Ward DE, Rowland E (1989) Efficacy and safety of adenosine in the treatment of supraventricular tachycardia in infants and children.Br Heart J 62:204–211