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Adenosine Induced Torsades de Pointes in a Child with Congenital Long QT Syndrome
Author(s) -
ÇELIKER ALPAY,
TOKEL KÜRÇAD,
ÇIL ERGUN,
ÖZKUTLU SÜHEYLA,
ÖZME ÇENCAN
Publication year - 1994
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1994.tb03752.x
Subject(s) - torsades de pointes , medicine , adenosine , qt interval , bradycardia , long qt syndrome , cardiology , sinus bradycardia , sick sinus syndrome , heart disease , anesthesia , heart rate , blood pressure
Torsades de pointes is a rare arrhythmia characterized by its bradycardia dependence and increased adrenergic discharge, whether it occurs as a congenital anomaly or as an acquired problem resuiting from drug intoxication or other conditions. There are no reliable tests to assess the propensity toward torsades de pointes or evaluate the efficacy of treatment in these patients. Adenosine can result in marked slowing of sinus and ventricular rate and leads to increased sympathic discharge when given intravenously. We induced torsades de pointes in a child with congenital long QT syndrome (Jervell‐Lange‐Nielsen syndrome) using 200 μg/kg IV adenosine bolus. Higher dosage of adenosine (600 μg/kg) did not lead to torsades de pointes after β blockade. Adenosine may induce torsades de pointes in patients with the long QT syndrome and may be used as a test to reproduce the clinical arrhythmia. Whether adenosine proves to be useful for assessing the efficacy of treatment will require extensive investigation in larger series of patients.