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Ventricular Fibrillation Precipitated by Intracoronary Adenosine During Fractional Flow Reserve Assessment - A
Ashish H Shah1, William Chan1, Peter H Seidelin1
1Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Abstract:
Fractional flow reserve (FFR) measurement is the current benchmark for assessing the physiologic significance of a coronary stenosis. Intravenous / intra-coronary adenosine is a commonly used agent to induce hyperaemia, required for FFR measurement. In our institute, we have observed three cases of ventricular fibrillation (VF) after intra-coronary adenosine injection. Volume of the injections appeared to be the responsible mechanism, supported by evidence from optical coherence tomography (OCT) experience. Since doubling the concentration of adenosine to reduce the volume of injection by half, no further incidence of VF has been noted.
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