Imperial College London
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Dr Fu Siong Ng

Faculty of Medicine, National Heart & Lung Institute

Reader in Cardiac Electrophysiology
 
 
 
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Contact

 

+44 (0)20 7594 3614f.ng Website

 
 
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Location

 

430ICTEM buildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rajkumar:2017:10.1186/s13256-016-1177-z,
author = {Rajkumar, CA and Qureshi, N and Ng, F and Panoulas, VF and Lim, PB},
doi = {10.1186/s13256-016-1177-z},
journal = {Journal of Medical Case Reports},
title = {Adenosine induced ventricular fibrillation in a structurally normal heart: a case report},
url = {http://dx.doi.org/10.1186/s13256-016-1177-z},
volume = {11},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundAdenosine is the first-line pharmacotherapy for termination of supraventricular tachycardia through its action on the atrioventricular node. However, pro-arrhythmic effects of adenosine are also recognised, most notably in the presence of pre-excited atrial fibrillation. In this case report, we describe the induction of ventricular fibrillation in a patient with no demonstrable accessory pathway, nor any other structural heart disease. This rare, idiosyncratic reaction has never previously been reported and is of relevance given the widespread and routine use of adenosine in clinical practice.Case presentationA 26-year-old woman of Cypriot origin presented to our emergency department with a sudden onset of palpitations and chest discomfort. She was healthy, with no previous medical history and no regular medications. An electrocardiogram demonstrated a narrow complex tachycardia with a rate of 194 beats per minute. Following failure of vagal maneuvers to terminate the tachycardia, the assessing physician administered a single intravenous dose of 6 mg adenosine. Our patient instantaneously developed coarse ventricular fibrillation and circulatory collapse. Cardiopulmonary resuscitation was initiated and our patient was rapidly defibrillated to sinus rhythm with a single 150 J direct current shock. A 900-mg loading dose of intravenous amiodarone was commenced and our patient was managed in the cardiac high dependency unit. No further arrhythmias were identified on continuous cardiac monitoring.On review, her presenting electrocardiogram had demonstrated rapidly conducted atrial fibrillation with no evidence of ventricular pre-excitation. Concordantly, her resting electrocardiogram was not suggestive of any accessory pathway. This was conclusively excluded on invasive electrophysiology study, with negative programmed ventricular stimulation up to three extrastimuli. Extensive laboratory investigations were unremarkable and failed to identify an underlying cau
AU  - Rajkumar,CA
AU  - Qureshi,N
AU  - Ng,F
AU  - Panoulas,VF
AU  - Lim,PB
DO  - 10.1186/s13256-016-1177-z
PY  - 2017///
SN  - 1752-1947
TI  - Adenosine induced ventricular fibrillation in a structurally normal heart: a case report
T2  - Journal of Medical Case Reports
UR  - http://dx.doi.org/10.1186/s13256-016-1177-z
UR  - http://hdl.handle.net/10044/1/43218
VL  - 11
ER  -
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