Supraventricular Tachycardia

Lerman, Bruce B.; Markowitz, Steven M.; Cheung, Jim W.; Liu, Christopher F.; Thomas, George; Ip, James E.

doi:10.1161/circep.118.006953

Cited by 14 publications

(7 citation statements)

References 48 publications

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“…The electrophysiological action of adenosine in the heart is regionally variable and dependent on the underlying ionic current population, which differ between species [ 41 ]. Irrespective of the species, adenosine exerts its cardiac electrophysiological actions mainly through the modulation of potassium, sodium and calcium currents by cardiac A 1 and A 2A receptors’ activation [ 60 , 61 ].…”

Section: Adenosinergic System Signalingmentioning

confidence: 99%

“…The direct activation of IK,Ado induces a hyperpolarization of sinoatrial nodal cells and decreases the slope of the diastolic depolarization and the repolarization duration. Because the sinoatrial node is under the influence of the sympathetic nervous system, the anti-β-adrenergic effect secondary to A 1 R activation limits the cAMP-dependent currents (If and ICa,L), which further decreases the slope of the diastolic depolarization [ 41 , 60 , 63 ] ( Figure 4 A).…”

Section: Adenosinergic System Signalingmentioning

confidence: 99%

“…Whereas the nodal-his bundle cells are insensitive to adenosine, adenosine decreases the action potential duration in atrio-nodal cells. The most important action occurs on nodal cells, since the concentration-dependent effect of adenosine can decrease the amplitude and duration of the action potential and abolish the action potential at high concentrations of adenosine [ 41 , 60 , 68 ].…”

Section: Adenosinergic System Signalingmentioning

confidence: 99%

“…However, adenosine shortens the action potential duration and decreases the refractory period thanks to the IK,Ado outward current, which increases the potassium repolarization flux ( Figure 4 B). It is noteworthy that under adrenergic stimulation adenosine can also reduce the cAMP-dependent effect on ICa,L in atrial cells [ 55 , 60 , 91 ] Moreover, this shortening of the atrial action potential by the direct and fast onset of IK,Ado may reduce the time needed for the slowed onset of cAMP-dependent pathways, leading to cardiac electromechanical coupling and thereby depressing the twitch amplitude and decreasing the atrial contractile force [ 55 ].…”

Section: Adenosinergic System Signalingmentioning

confidence: 99%

“…Using these characteristics, the major diagnosis interest and clinical use of adenosine is due to the fact of its action on an atrioventricular node. It confers to adenosine its diagnosis properties used in supra ventricular tachycardia [ 60 , 61 ]. While shortening the action potential duration, adenosine can also elicit a post-repolarization refractoriness prolongation [ 92 ].…”

Section: Adenosinergic System Signalingmentioning

confidence: 99%

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Adenosine and Adenosine Receptors: Advances in Atrial Fibrillation

et al. 2022

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Atrial fibrillation (AF) is the most common arrhythmia in the world. Because the key to developing innovative therapies that limit the onset and the progression of AF is to fully understand the underlying molecular mechanisms of AF, the aim of the present narrative review is to report the most recent advances in the potential role of the adenosinergic system in the pathophysiology of AF. After a comprehensive approach describing adenosinergic system signaling and the mechanisms of the initiation and maintenance of AF, we address the interactions of the adenosinergic system’s signaling with AF. Indeed, adenosine release can activate four G-coupled membrane receptors, named A1, A2A, A2B and A3. Activation of the A2A receptors can promote the occurrence of delayed depolarization, while activation of the A1 receptors can shorten the action potential’s duration and induce the resting membrane’s potential hyperpolarization, which promote pulmonary vein firing, stabilize the AF rotors and allow for functional reentry. Moreover, the A2B receptors have been associated with atrial fibrosis homeostasis. Finally, the adenosinergic system can modulate the autonomous nervous system and is associated with AF risk factors. A question remains regarding adenosine release and the adenosine receptors’ activation and whether this would be a cause or consequence of AF.

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Section: Adenosinergic System Signalingmentioning

confidence: 99%

Section: Adenosinergic System Signalingmentioning

confidence: 99%

Section: Adenosinergic System Signalingmentioning

confidence: 99%

Section: Adenosinergic System Signalingmentioning

confidence: 99%

Section: Adenosinergic System Signalingmentioning

confidence: 99%

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Adenosine and Adenosine Receptors: Advances in Atrial Fibrillation

et al. 2022

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Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

Peng,

Zei

2024

JAMA

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ImportanceParoxysmal supraventricular tachycardia (PSVT), defined as tachyarrhythmias that originate from or conduct through the atria or atrioventricular node with abrupt onset, affects 168 to 332 per 100 000 individuals. Untreated PSVT is associated with adverse outcomes including high symptom burden and tachycardia-mediated cardiomyopathy.ObservationsApproximately 50% of patients with PSVT are aged 45 to 64 years and 67.5% are female. Most common symptoms include palpitations (86%), chest discomfort (47%), and dyspnea (38%). Patients may rarely develop tachycardia-mediated cardiomyopathy (1%) due to PSVT. Diagnosis is made on electrocardiogram during an arrhythmic event or using ambulatory monitoring. First-line acute therapy for hemodynamically stable patients includes vagal maneuvers such as the modified Valsalva maneuver (43% effective) and intravenous adenosine (91% effective). Emergent cardioversion is recommended for patients who are hemodynamically unstable. Catheter ablation is safe, highly effective, and recommended as first-line therapy to prevent recurrence of PSVT. Meta-analysis of observational studies shows single catheter ablation procedure success rates of 94.3% to 98.5%. Evidence is limited for the effectiveness of long-term pharmacotherapy to prevent PSVT. Nonetheless, guidelines recommend therapies including calcium channel blockers, β-blockers, and antiarrhythmic agents as management options.Conclusion and RelevanceParoxysmal SVT affects both adult and pediatric populations and is generally a benign condition. Catheter ablation is the most effective therapy to prevent recurrent PSVT. Pharmacotherapy is an important component of acute and long-term management of PSVT.

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