Adenosine: electrophysiologic effects and therapeutic use for terminating paroxysmal supraventricular tachycardia.

Abstract

Adenosine was administered intravenously to 17 patients undergoing intracardiac electrophysiologic studies. At a mean dose of 179 + 88 /ag/kg (±+ SD), adenosine suppressed sinus node automaticity and depressed atrioventricular (AV) nodal conduction. These effects were less than 20 sec in duration and were not influenced by muscarinic blockade with atropine (0.02 to 0.03 mg/kg). Adenosine at this dose had no Received June 20, 1983; revision accepted August 18, 1983. Dr. Belardinelli is the recipient of an NIH Research Career Development Award (1 K04 HL00969-0l).Dr. Sellers is the recipient of an American Heart Association Virginia Affiliate fellowship award 5-31757. 1254sinus rate and AV conduction in humans, but they reported no effect on atrial arrhythmias. We have recently demonstrated in isolated guinea pig and rabbit hearts and in the heart of the anesthetized dog in situ that the AV delay produced by adenosine is localized to the AV node.6 I Data from our laboratory and others have also suggested that adenosine released during ischemia or hypoxia may mediate the sinus bradycardia or AV nodal block seen in these conditions.7-9 These effects of adenosine in animals appear to be the result of an interaction with a specific extracellular receptor that is blocked by methylxanthines but not by atropine.'0The dose-response relationship of adenosine for its electrophysiologic and hemodynamic effects in man has not been previously characterized. In this study we sought to determine the nature and time course of the electrophysiologic effects of graded doses of intravenous adenosine in man and to assess the hemodynamic changes produced by the doses required to produce these effects. We also sought to test the hypothesis that the production of transient AV nodal block by an intravenous bolus of adenosine might permit the safe and CIRCULATION

Cardiac purinergic signalling in health and disease

“…ATP was shown to evoke transient tachycardia at low doses and to induce AV block at high doses [659,660]. Later, adenosine was also found to be effective in the acute termination of PSVT [661,662] and was used effectively in children [663][664][665][666]. The mechanism of terminating the arrhythmias by either adenosine or ATP is the induction of transient complete AV nodal conduction block.…”

Transient bradycardia and subsequent sinus tachycardia produced by intravenous adenosine in healthy adult subjects.

“…The effect of adenosine on the heart rate of subjects with no heart disease have not yet been defined. Di Marco et al (1983) also comment on a 'mild sinus tachycardia' following the brief period of bradycardia, but do not further describe this phenomenon. We therefore investigated the dose-response relationship of the effects of adenosine on heart rate in healthy volunteers.…”

New therapeutics and drugs available in Turkey

“…Sinüs ve AV nodları ise ilacın fizyolojik dozlarına çok hassas olup AV nodu tutan akut paroksismal supraventriküler taşikardi (PSVT) ataklarının sonlandırılmasında son derece etkilidir. [11] Hızlı IV bolus olarak uygulandığında kardiyak iletiyi yavaşlatırken sü-rekli infüzyon şeklinde verildiğinde güçlü bir vazodilatör etki göstererek talyum-201 miyokard perfüzyon sintigrafisinin yapılmasına yardımcı olur. İntravenöz enjeksiyon yapıldığın-da AV iletim üzerindeki etkinin süresi son derece kısadır (yaklaşık 30 sn).…”