PMID- 22201017
OWN - NLM
STAT- MEDLINE
DCOM- 20120925
LR  - 20151119
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 14
IP  - 6
DP  - 2012 Jun
TI  - Sinus nodal response to adenosine relates to the severity of sinus node 
      dysfunction.
PG  - 859-64
LID - 10.1093/europace/eur399 [doi]
AB  - AIMS: It is unknown as to whether the result of adenosine testing for the 
      diagnosis of sinus node dysfunction (SND) depends on the clinical presentation. 
      We investigated whether syncope or presyncope are associated with a more 
      pronounced sinus nodal inhibition by adenosine in SND. METHODS AND RESULTS: We 
      studied 46 patients with SND, 33 with syncope or presyncope and 13 without such 
      history. Controls were 30 subjects undergoing electrophysiological studies for 
      supraventricular tachycardia or unexplained syncope. We calculated the corrected 
      sinus node recovery time after intravenous adenosine 0.15 mg/kg (ADSNRT) as well 
      as after atrial pacing (CSNRT). Corrected sinus node recovery time values >525 ms 
      were considered abnormal. Corrected sinus node recovery time after adenosine 
      injection was more prolonged in SND patients with syncope or presyncope as 
      compared with those without such history [median: 4900 inter-quartile range 
      (IQR): 920-8560 ms vs. median: 280 IQR: 5-908 ms; P< 0.005]. In SND patients with 
      syncope or presyncope ADSNRT was more prolonged than CSNRT (median: 4900 IQR: 
      920-8560 ms vs. median: 680 IQR: 359-1650 ms, P< 0.01). In SND patients without 
      syncope or presyncope no statistical difference was noted between ADSNRT and 
      CSNRT (median: 280 IQR: 5-908 ms vs. median: 396 IQR: 270-600 ms, P = 0.80). The 
      sensitivity of CSNRT for SND diagnosis was 57% and the specificity was 100%. A 
      cut-off of 1029 ms for ADSRNT yields the same sensitivity with a specificity of 
      96.6%. CONCLUSION: In patients with SND syncope or presyncope relate to an 
      exaggerated sinus nodal suppression by adenosine. Prolonged ADSNRT can diagnose 
      cases with severe underlying SND where a more aggressive management strategy is 
      probably warranted.
FAU - Fragakis, Nikolaos
AU  - Fragakis N
AD  - 3rd Cardiology Department, Hippokration Hospital, Aristotle University Medical 
      School, 49 Konstantinoupoleos Street, 54642 Thessaloniki, Greece. 
      fragakis.nikos@googlemail.com
FAU - Antoniadis, Antonios P
AU  - Antoniadis AP
FAU - Korantzopoulos, Panagiotis
AU  - Korantzopoulos P
FAU - Kyriakou, Panagiota
AU  - Kyriakou P
FAU - Koskinas, Konstantinos C
AU  - Koskinas KC
FAU - Geleris, Paraschos
AU  - Geleris P
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20111226
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
RN  - 0 (Anti-Arrhythmia Agents)
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - *Adenosine/administration & dosage
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Arrhythmia Agents/administration & dosage
MH  - Cardiac Pacing, Artificial/methods
MH  - Female
MH  - Humans
MH  - Injections, Intravenous
MH  - Male
MH  - Middle Aged
MH  - ROC Curve
MH  - Reaction Time/drug effects
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Sick Sinus Syndrome/*diagnosis
MH  - Sinoatrial Node/*drug effects/physiopathology
MH  - Syncope/*diagnosis
EDAT- 2011/12/28 06:00
MHDA- 2012/09/26 06:00
CRDT- 2011/12/28 06:00
PHST- 2011/12/28 06:00 [entrez]
PHST- 2011/12/28 06:00 [pubmed]
PHST- 2012/09/26 06:00 [medline]
AID - eur399 [pii]
AID - 10.1093/europace/eur399 [doi]
PST - ppublish
SO  - Europace. 2012 Jun;14(6):859-64. doi: 10.1093/europace/eur399. Epub 2011 Dec 26.