Title

Ventricular fibrillation with intracoronary adenosine during fractional flow reserve assessment.

Publication/Presentation Date

7-20-2016

Abstract

Fractional flow reserve (FFR) measurement provides useful hemodynamic assessment of intermediate coronary stenoses affecting long term outcomes. While the gold standard remains intravenous adenosine, intracoronary (IC) bolus administration of adenosine is routinely used in clinical practice because of its ease of use and lower dose providing comparative hyperemia with the most common side effect being a transient atrioventricular block. A 62year old male underwent left heart catheterization after ruling in for non-ST elevation myocardial infarction (NSTEMI). Presenting electrocardiogram (ECG) showed an old left bundle branch block and T-wave inversions in lateral leads (QTc 494ms) with no significant electrolyte abnormalities. Coronary angiography revealed an intermediate lesion in mid left anterior descending coronary artery. FFR assessment with IC adenosine (24μg/mL of normal saline) was performed inducing ventricular fibrillation (VF). He was successfully defibrillated with a single 200J shock and no further arrhythmias were noticed during rest of his hospital stay.

Volume

17

Issue

7

First Page

487

Last Page

489

ISSN

1878-0938

Disciplines

Medical Sciences | Medicine and Health Sciences

PubMedID

27477304

Department(s)

Department of Medicine, Cardiology Division, Department of Medicine Faculty

Document Type

Article