Sinus arrest during adenosine stress testing in liver transplant recipients with graft failure: three case reports and a review of the literature.
Publication/Presentation Date
1-1-2005
Abstract
BACKGROUND: Nuclear stress imaging is used frequently to evaluate patients with end-stage liver disease who are being considered for orthotopic liver transplantation.
METHODS AND RESULTS: We present three patients who, following graft failure, developed sinus arrest during adenosine stress testing performed in anticipation of repeat liver transplantation. All had undergone uneventful adenosine stress imaging prior to initial transplantation. The mechanisms of action, pharmacokinetics, and pharmacodynamics of adenosine are reviewed, and possible reasons for this phenomenon are discussed. Finally, cautions regarding the use of adenosine and treatment of adenosine-induced sinoatrial and atrioventricular block are reviewed.
CONCLUSION: Adenosine should be used with caution in patients following orthotopic liver transplantation due to an increased risk of sinus arrest. Should sinus arrest or atrioventricular block occur, it appears to respond readily to cessation of adenosine infusion and intravenous aminophylline with no significant sequelae.
Volume
12
Issue
6
First Page
696
Last Page
702
ISSN
1071-3581
Published In/Presented At
Giedd, Kenneth N et al. “Sinus arrest during adenosine stress testing in liver transplant recipients with graft failure: three case reports and a review of the literature.” Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology vol. 12,6 (2005): 696-702. doi:10.1016/j.nuclcard.2005.07.007
Disciplines
Medicine and Health Sciences
PubMedID
16344232
Department(s)
Department of Medicine
Document Type
Article