Life-threatening alterations in heart rate after the use of adenosine in atrial flutter

Michael A. Brodsky, Chun Hwang, Dodie Hunter, Peng Sheng Chen, David Smith, Mehrdad Ariani, Warren D. Johnston, Byron J. Allen, James G. Chun, Claudia R. Gold

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32 Scopus citations


Adenosine has become the preferred treatment for common types of supraventricular tachycardia because it is extremely effective and rarely associated with serious side effects. It has also been advocated as an intervention for diagnostic use to assess uncommon types of tachycardia. Evidence is shown in this report that adenosine was associated with dangerous worsening of arrhythmia in patients with atrial flutter. In two patients, adenosine precipitated acceleration of ventricular response, in one case necessitating emergent cardioversion. Both patients had atrial flutter with 2 to 1 atrioventricular block that evolved into 1 to 1 atrioventricular conduction. In three other patients, adenosine was associated with prolonged bradyasystole and hypotension. In each of the five patients, adenosine was given in a standard fashion (6 or 12 mg). In summary, adenosine should be recognized as a potentially dangerous intervention in patients with atrial flutter. If it is used for diagnostic purposes, resuscitative equipment should be readily available.

Original languageEnglish (US)
Pages (from-to)564-571
Number of pages8
JournalAmerican Heart Journal
Issue number3 PART 1
StatePublished - Sep 1995


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Brodsky, M. A., Hwang, C., Hunter, D., Chen, P. S., Smith, D., Ariani, M., Johnston, W. D., Allen, B. J., Chun, J. G., & Gold, C. R. (1995). Life-threatening alterations in heart rate after the use of adenosine in atrial flutter. American Heart Journal, 130(3 PART 1), 564-571.