![]() ![]() Most notably, receptors found in the cardiac atrioventricular (AV) nodal tissue and within the peripheral vasculature exhibit clinical manifestations when administering adenosine. describe four types of adenosine receptors: A1, A2a, A2B, and A3, affecting the immune, nervous, circulatory, respiratory, and urinary systems. Adenosine’s use as a pharmacological drug works through receptors called purinergic adenosine receptors found throughout the body. Lastly, neurohumoral syncope is believed to be caused by low plasma concentrations of endogenous adenosine that differ from classical vasovagal syncope.Īdenosine is a purine nucleoside base, most commonly recognized with the molecule adenosine triphosphate, or ATP, and is used thoroughly throughout the entire body in general metabolism. Before and after ablation procedures, adenosine can be used to determine accessory pathway conduction which can also be helpful in pulmonary vein isolation. Adenosine can be used diagnostically for patients with narrow QRS complex tachycardia. Adenosine can be useful in treating wide QRS tachycardia that is hemodynamically stable when it is difficult to differentiate between supraventricular tachycardia and ventricular tachycardia. Adenosine also stops triggered ventricular arrhythmias and many focal atrial tachycardias. Adenosine stops atrioventricular nodal arrhythmias, e.g., atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia. ![]() However, adenosine is more stable at room temperature than adenosine triphosphate. Continuous electrocardiogram recordings during adenosine administration can aid clinicians in differentiating between true adenosine resistance (non- atrioventricular node) and transient adenosine effect (short half-life).Īdenosine triphosphate is metabolized into adenosine when given intravenously was used to treat arrhythmias, and it has similar clinical efficacy to intravenous adenosine. Adenosine failure can occur for two main reasons in treating supraventricular tachycardia: 1) It has a very short half-life, and 2) A non- atrioventricular node-dependent supraventricular tachycardia. Adenosine primarily affects the atrioventricular node to stop the arrhythmia. Pediatric supraventricular tachycardia is often dependent on the atrioventricular node for its propagation. The 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care (pediatric life support) gives adenosine a class I recommendation for hemodynamically stable supraventricular tachycardia. The clinicians concluded that higher doses of adenosine might be necessary for refractory supraventricular tachycardia. The infant returned to sinus rhythm with a higher dose of adenosine. The clinicians tried electrical cardioversion, but the supraventricular tachycardia was resistant. An infant presented with unstable supraventricular tachycardia. If not promptly treated, it can cause cardiogenic shock and heart failure. Pediatric supraventricular tachycardia is a common arrhythmia with great clinical significance. Second-line treatments include beta-blockers and calcium channel blockers. The European Society of Cardiology guidelines advocates using vagal maneuvers and adenosine as first-line therapies in diagnosing and treating supraventricular tachycardia. However, trabodenoson was not found to be effective in a phase III clinical trial. The experimental adenosine A1 receptor agonist, trabodenoson, is proposed to increase aqueous humor outflow by stimulating trabecular meshwork cells’ production of matrix metalloproteinases which clears accumulated debris from the eye. Endogenous adenosine appears to play a role in the pathophysiology of glaucoma. Worldwide, glaucoma is the second leading cause of blindness. Therapeutically, adenosine is used for its antiarrhythmic properties in supraventricular tachycardia (SVT) and can function as a diagnostic tool, depending on the type of SVT. Diagnostically, adenosine is one pharmaceutical agent used in a myocardial perfusion stress imaging study for its vasodilatory effects. Adenosine can serve as a diagnostic or therapeutic agent. ![]()
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