A Young Woman with Regular Narrow Complex Tachy at both 160 and 240

This article studied their effect in pediatrics:https://www.ahajournals.org/doi/full/10.1161/CIRCEP.109.901629===================================MY Comment by KEN GRAUER, MD (5/30/2020):===================================Fascinating case presented by Dr. Smith (!) — about this young woman who presented with palpitations and sequential reentry SVT rhythms — initially at a ventricular rate of ~160/minute — and then following administration of 6mg IV adenosine, another reentry SVT at a much faster rate of ~240/minute. HOW could this happen?For clarity — I have put together the 3 ECGs from today’s case in Figure-1.Dr. Smith has reviewed (above) the pathophysiology of dual AV nodal pathways responsible for sustaining reentry SVT rhythms. I focus My Comment on additional insights to be gained from this case.Figure-1: The 3 ECGs shown in today ’s case (See text).ADENOSINE is NOT Always Benign: Adenosine ’s reputation as a superb, rapid-acting agent for treatment of reentry SVT rhythms is well established. The drug acts immediately — with a half-life of less than 10 seconds. As a result — any adverse effects that may be produced will almost always be short-lived (typically resolving within 30-to-90 seconds).Common adverse effects (that are to be expected) following IV adenosine include: i) ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs