Khan Zubair A, Akbar Ghulam, Saeed Wajeeha, Malik Sara, Khan Fatima, Sardar Muhammad Rizwan
Cooper University Hospital, Camden, NJ 08103, USA.
Lehigh Valley Hospital, Allentown, PA 18103, USA.
Cardiovasc Revasc Med. 2016 Oct-Nov;17(7):487-489. doi: 10.1016/j.carrev.2016.07.004. Epub 2016 Jul 20.
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.
血流储备分数（FFR）测量可为影响长期预后的中度冠状动脉狭窄提供有用的血流动力学评估。虽然金标准仍是静脉注射腺苷，但冠状动脉内（IC）推注腺苷在临床实践中常规使用，因为其使用方便且剂量较低，能提供相当的充血效果，最常见的副作用是短暂的房室传导阻滞。一名62岁男性在确诊非ST段抬高型心肌梗死（NSTEMI）后接受了左心导管检查。入院心电图（ECG）显示陈旧性左束支传导阻滞及侧壁导联T波倒置（QTc 494毫秒），无明显电解质异常。冠状动脉造影显示左前降支冠状动脉中段有一中度病变。使用IC腺苷（24μg/mL生理盐水）进行FFR评估时诱发了心室颤动（VF）。他通过单次200J电击成功除颤，在住院期间其余时间未再出现心律失常。
