Adenosine induced atrial fibrillation precipitating polymorphic ventricular tachycardia

Pacing Clin Electrophysiol. 2000 Jan;23(1):140-1. doi: 10.1111/j.1540-8159.2000.tb00662.x.

Abstract

An 86-year-old female developed supraventricular tachycardia 36 hours after a myocardial infarction (MI). She developed atrial fibrillation and polymorphic ventricular tachycardia (PVT) following administration of 12 mg of adenosine. The PVT caused hemodynamic instability with no response to cardioversion, but termination with procainamide. The heart is vulnerable to hemodynamically unstable, possibly lethal, PVT early after MI under some circumstances. This vulnerability may be exposed following administration of adenosine. Extra caution is warranted when using adenosine in the post-MI period.

Publication types

  • Case Reports

MeSH terms

  • Adenosine / adverse effects*
  • Aged
  • Aged, 80 and over
  • Anti-Arrhythmia Agents / adverse effects*
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / chemically induced*
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / physiopathology
  • Electrocardiography / drug effects
  • Female
  • Heart Rate / drug effects
  • Humans
  • Infusions, Intravenous
  • Myocardial Infarction / complications
  • Procainamide / administration & dosage
  • Procainamide / therapeutic use
  • Tachycardia, Supraventricular / drug therapy*
  • Tachycardia, Supraventricular / etiology

Substances

  • Anti-Arrhythmia Agents
  • Adenosine
  • Procainamide