RESUMO
Adenosine is frequently used in emergency departments and intensive care units for the termination of narrow complex tachycardias. Recently its utility in terminating wide complex tachycardias has been reported in the literature. Adenosine is generally felt to be a safe medication even though its proarrhythmic effects in the setting of narrow complex or supraventricular tachycardias have been well documented. Herein, we describe the first case to our knowledge of adenosine inducing ventricular fibrillation in a patient with a stable wide complex tachycardia that was subsequently proven to be ventricular tachycardia at electrophysiologic study.
Assuntos
Adenosina/efeitos adversos , Antiarrítmicos/efeitos adversos , Taquicardia Ventricular/fisiopatologia , Fibrilação Ventricular/induzido quimicamente , Técnicas Eletrofisiológicas Cardíacas , Feminino , Humanos , Pessoa de Meia-Idade , Taquicardia Ventricular/complicaçõesRESUMO
This report describes a modified defibrillation technique used successfully in a patient with an implanted epicardial cardioverter defibrillator who developed refractory ventricular fibrillation. During operative testing at the time of generator replacement, two episodes of intractable ventricular fibrillation were terminated by using a combined internal (epicardial)-external (transthoracic) defibrillation system that delivered a 360-J shock between the anterior epicardial patch and a large posterior skin electrode.
