Adenosine‐induced Atrial Fibrillation

Address for correspondence: Stelan H. Hohnloser. M.D., Depanment of Medicine, Division of Ciirdiology, J W Goeihe University, TheodorStem-Kai 7, 60590 Frankfun. Germany. Fax: 49-6173-950290; E-mail: hohnloser@cm.uni-frankfurl.de Repeated carotid sinu.s pressure was attempted but failed to interrupt the tachycardia. In each instance, the tachycardia was terminated by adtninistration of adenosine 12 mg. In all four episodes, atrial iibriliation ensued after the first or second sinus beat after tachycardia termination by adenosine. Atrial Hbrillation terminated spontaneously after a few minutes. This example demonstrates the well-known potential of adenosine to provoke atrial fibrillation, which may be hazardous, particularly in patients with anterograde conduction over an accessory pathway. In this case, supraventricular tachycardia was caused by a concealed left-sided accessory pathway that was successfully ablated.