Reentry tachycardia in children: adenosine can make it worse

Objectives We report on a rare but severe complication of adenosine use in a child with reentry tachycardia. - Methods and Results Treatment with adenosine, which is the standard medical therapy of atrioventricular reentry tachycardia, led to the development of an irregular wide complex tach...

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Hauptverfasser: Hien, Maximilian (VerfasserIn) , Benito Castro, Fernando (VerfasserIn) , Fournier, Philippe (VerfasserIn) , Filleron, Anne (VerfasserIn) , Tran, Tu-Anh (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 2018
In: Pediatric emergency care
Year: 2018, Jahrgang: 34, Heft: 12, Pages: e239-e242
ISSN:1535-1815
DOI:10.1097/PEC.0000000000000951
Online-Zugang:Verlag, Volltext: https://doi.org/10.1097/PEC.0000000000000951
Verlag, Volltext: https://journals.lww.com/pec-online/fulltext/2018/12000/Reentry_Tachycardia_in_Children__Adenosine_Can.20.aspx
Volltext
Verfasserangaben:Maximilian D. Hien, MD, Fernando Benito Castro, MD, Philippe Fournier, MD, Anne Filleron, MD, and Tu-Anh Tran, PhD
Beschreibung
Zusammenfassung:Objectives We report on a rare but severe complication of adenosine use in a child with reentry tachycardia. - Methods and Results Treatment with adenosine, which is the standard medical therapy of atrioventricular reentry tachycardia, led to the development of an irregular wide complex tachycardia, caused by rapid ventricular response to atrial fibrillation. The girl was finally stabilized with electrical cardioversion. We analyze the pathomechanism and discuss possible treatment options. - Conclusions Atrial fibrillation, as well as its conduction to the ventricles, can be caused by adenosine. Rapid ventricular response in children with Wolff-Parkinson-White syndrome is more frequent than previously believed. A patient history of atrial fibrillation is a contraindication for cardioversion with adenosine and needs to be assessed in children with reentry tachycardia. High-risk patients may potentially profit from prophylactic comedication with antiarrhythmic agents, such as flecainide, ibutilide, or vernakalant, before adenosine administration.
Beschreibung:Gesehen am 14.01.2020
Beschreibung:Online Resource
ISSN:1535-1815
DOI:10.1097/PEC.0000000000000951