Heart 1998;80:330-333 ( October )
Adenosine induced transient cardiac standstill in catheter interventional procedures for congenital heart disease
a Heart Unit, Birmingham Children's Hospital NHS Trust,
Ladywood Middleway, Birmingham B16 8ET, UK, b Department of Anaesthetics, Birmingham
Children's Hospital NHS Trust
Correspondence to: Dr De Giovanni.
Accepted for publication 18 June 1998
Objective
To describe the use of intravenous
adenosine to create transient cardiac standstill during balloon
dilatation procedures for congenital heart defects.
SettingA tertiary paediatric cardiac centre.
Design and patientsThis was a prospective pilot
study. Thirteen patients born with congenital heart disease and who had
stenotic lesions requiring relief were considered for the technique.
All were suitable for balloon dilatation. Their ages ranged from 2 months to 30 years, mean (SD) 9.9 (9.8) years. The dose of adenosine
varied from 0.125 mg/kg to 0.555 mg/kg, mean 0.33 (0.127).
ResultsTwo patients only developed sinus
bradycardia in response to adenosine, which may have been related to
the technique of administration. The other 11 experienced a period of
asystole, which ranged from 2.4 to 10.8 seconds, mean 4.99 (2.27), and
a total atrioventricular block period of 5.0 to 21.2 seconds, mean 9.47 (4.64). The interval between adenosine injection and the onset of
asystole varied from 2.4 to 15.8 seconds, mean 8.05 (3.6), depending on
cannula size, site of administration, and cardiac output. The peak
gradient across the stenotic lesions fell from 52.3 (23.7) to 17.8 (11.9) mm Hg (p < 0.001). Apart from one short episode of atrial
fibrillation there were no complications.
ConclusionsIntravenous adenosine is a safe and
effective agent for creating transient cardiac standstill during
balloon dilatation procedures for congenital heart disease. This
achieves stability which is likely to improve results and reduce
complications. It may have applications in other fields of cardiac
intervention where an immobile heart is desirable during the critical
phase of a procedure.
© 1998 by Heart
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Ector, J., De Buck, S., Nuyens, D., Rossenbacker, T., Huybrechts, W., Gopal, R., Maes, F., Heidbuchel, H.
(2009). Adenosine-induced ventricular asystole or rapid ventricular pacing to enhance three-dimensional rotational imaging during cardiac ablation procedures. Europace
11: 751-762
[Abstract] [Full Text] -
Daehnert, I, Rotzsch, C, Wiener, M, Schneider, P
(2004). Rapid right ventricular pacing is an alternative to adenosine in catheter interventional procedures for congenital heart disease. Heart
90: 1047-1050
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
