Related Experiment Videos
Adenosine induced atrial fibrillation precipitating polymorphic ventricular tachycardia
I V Kaplan1, A V Kaplan, J D Fisher
1Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Pacing and Clinical Electrophysiology : PACE
|February 10, 2000
Summary
Following myocardial infarction (MI), the heart may become vulnerable to lethal polymorphic ventricular tachycardia (PVT), especially after adenosine administration. Caution is advised when using adenosine in the post-MI period.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Pharmacology
Background:
- Myocardial infarction (MI) can precipitate various cardiac arrhythmias.
- Supraventricular tachycardia (SVT) is a known complication post-MI.
- The electrophysiological substrate following MI can be complex and dynamic.
Observation:
- An 86-year-old female presented with SVT 36 hours post-MI.
- Administration of adenosine (12 mg) precipitated atrial fibrillation and polymorphic ventricular tachycardia (PVT).
- The patient experienced hemodynamic instability due to PVT.
Findings:
- Polymorphic ventricular tachycardia (PVT) in this case was resistant to cardioversion.
- Procainamide successfully terminated the hemodynamically unstable PVT.
- Adenosine administration appeared to unmask or precipitate PVT in the vulnerable post-MI heart.
Implications:
- The post-MI heart may exhibit a heightened vulnerability to potentially lethal PVT.
- Adenosine, a common antiarrhythmic, may exacerbate this vulnerability under specific post-MI conditions.
- Clinicians should exercise increased caution when administering adenosine to patients in the early post-MI period due to the risk of PVT.