Adenosine‐induced complete heart block: Not so transient

Harvey, Martyn; Safih, Shameem; Wallace, Muir

doi:10.1111/j.1742-6723.2007.01028.x

Cited by 7 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 In addition, it has an ultrashort half-life making it essentially of no use for patients with multiple recurring SVTs, an SVT recurrence rate of 9-57%, pro-arrhythmic effect with rare but potentially lethal polymorphic ventricular tachycardia, bronchospasm and a reported dose dependent efficacy between 70% and 95%. [2][3][4][5] Verapamil and diltiazem have also been associated with adverse effects, including ventricular dysfunction, hypotension, and cardiovascular collapse particularly when given in infants and neonates. [6][7][8] Dexmedetomidine an alpha-2 adrenoreceptor agonist with primary sedative properties has recently been shown to have potential antiarrhythmic effects.…”

Section: R Eentrant Supraventricular Tachycardia (Svt)mentioning

confidence: 99%

Dexmedetomidine: Therapeutic Use for the Termination of Reentrant Supraventricular Tachycardia

Chrysostomou

Morell²,

Wearden³

et al. 2012

Congenit Heart Dis

View full text Add to dashboard Cite

show abstract

Section: R Eentrant Supraventricular Tachycardia (Svt)mentioning

confidence: 99%

Dexmedetomidine: Therapeutic Use for the Termination of Reentrant Supraventricular Tachycardia

Chrysostomou

Morell²,

Wearden³

et al. 2012

Congenit Heart Dis

View full text Add to dashboard Cite

show abstract

“…Adenosine is also capable to induce an impaired or blocked of atrioventricular nodal conduction in humans [42,46]. This is generally a short-lived, not too serious, adverse reaction, but prolonged complete heart block requiring intubation and temporary pacing has also been reported [47]. A 1 adenosine receptors are abundantly expressed in the AV junction.…”

Section: Basic Studies On Acute Actions Of Methylxanthines and Other mentioning

confidence: 99%

Xanthine Derivatives in the Heart: Blessed or Cursed?

Szentmiklósi¹,

Cseppentö²,

Gesztelyi³

et al. 2011

CMC

View full text Add to dashboard Cite

Methylxanthines, such as theophylline, have been used to treat cardiorespiratory disorders, whereas caffeine is the most widely consumed psychoactive agent in various soft drinks. Because of the worldwide use of these drugs and the recently synthesized xanthine derivatives, an intensive research on the cardiac actions of these substances is under progress. This review focuses on the molecular mechanisms involved in the actions of xanthine derivatives with special reference to their adenosine receptor antagonistic properties. The main basic and human studies on the action of xanthines on impulse initiation and conduction, as well as the electrophysiological and mechanical activity of the working myocardium will be overviewed. The potential beneficial and harmful actions of the methylxanthines will be discussed in light of the recent experimental and clinical findings. The pharmacological features and clinical observations with adenosine receptor subtype-specific xanthine antagonists are also the subject of this paper. Based on the adenosine receptor-antagonistic activity of these compounds, it can be raised that xanthine derivatives might inhibit the cardioprotective action of endogenous adenosine on various subtypes (A(1), A(2A), A(2B) and A(3)) of adenosine receptors. Adenosine is an important endogenous substance with crucial role in the regulation of cardiac function under physiological and pathological conditions (preconditioning, postconditioning, ischemia/reperfusion injury). Recent clinical studies show that acute administration of caffeine or theophylline can inhibit various types of preconditioning in human subjects. There are no human studies, however, for the cardiovascular actions of long-term administration of these drugs. Upregulation of adenosine receptors and increased effectiveness of adenosine receptor-related cardiovascular functions have been observed after long-lasting treatment with methylxanthines. In addition, there are data indicating that blood adenosine level increases after long-term caffeine administration. Since the salutary actions (and also the adverse reactions) of a number of xanthine derivatives are repeatedly shown, the main goal is the development of novel structures that mimic the actions of the conventional methylxanthines as lead compounds, but their adenosine receptor subtype-specificity is higher, their water solubility is optimal, and the unwanted reactions are minimized.

show abstract

“…Various have been reported in up to 13% of patients treated with adenosine, including prolonged AV block, paroxysmal atrial fibrillation, non‐ventricular tachycardia, transient premature ventricular complexes, torsades de points with prolonged QT syndrome and rapid atrial fibrillation or flutter 60–69 . Most of these arrhythmias are transient and recover spontaneously but, as noted above, there are case reports of life‐threatening tachyarrhythmias in patients with pre‐excited atrial fibrillation, and prolonged bradycardia in patients on concurrent AV blocking drugs 35,69,70 …”

Section: Side‐effectsmentioning

confidence: 99%

“…[60][61][62][63][64][65][66][67][68][69] Most of these arrhythmias are transient and recover spontaneously but, as noted above, there are case reports of life-threatening tachyarrhythmias in patients with pre-excited atrial fibrillation, and prolonged bradycardia in patients on concurrent AV blocking drugs. 35,69,70 Minor Non-life-threatening but unpleasant side-effects of dyspnoea, chest pain, flushing and headache occur in approximately 10% of patients. These are self-limiting and patients' recall of these can be reduced with the use of midazolam.…”

Section: Dose and Administrationmentioning

confidence: 99%