The therapeutic and diagnostic cardiac electrophysiological uses of adenosine

摘要: Adenosine is a purine nucleoside with rapid onset and brief duration of action after intravenous bolus administration. Its most prominent cardiac effect impairment or blockade atrioventricular nodal conduction, but other effects are depression automaticity the sinus node attenuation catecholamine-related ventricular after-depolarizations. The cell surface receptor A1 purinoceptor. therapeutic value adenosine predominantly in those arrhythmias which forms part reentry circuit, as clearly demonstrated by high success rate for termination tachycardia involving an accessory pathway Wolff-Parkinson-White syndrome. Ventricular tachycardias generally unresponsive, exception right outflow tract tachycardia. A diagnostic role has emerged adenosine. transient that it causes can reveal important electrocardiographic features arrhythmias, such atrial flutter, unmask latent preexcitation. In wide-QRS tachycardias, help to distinguish from supraventricular QRS aberration. Unlike verapamil, safe suggested dosing scheme give incremental doses at 1-minute intervals, starting 0.05 mg/kg continuing until complete block induced maximum 0.25 reached. Side transient, sometimes uncomfortable, not hazardous; dyspnea chest discomfort frequent. history asthma relative contraindication. Aminophylline antagonizes dipyridamole potentiates