Matthews Gareth Dk, Grace Andrew A
Cambridge University NHS Foundation Trust, Cambridge, UK.
Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Arrhythm Electrophysiol Rev. 2020 Feb 12;8(4):240-248. doi: 10.15420/aer.2019.05.
Adenosine was identified in 1929 and immediately recognised as having a potential role in therapy for arrhythmia because of its negative chronotropic and dromotropic effects. Adenosine entered mainstream use in the 1980s as a highly effective agent for the termination of supraventricular tachycardia (SVT) involving the atrioventricular node, as well as for its ability to unmask the underlying rhythm in other SVTs. Adenosine has subsequently been found to have applications in interventional electrophysiology. While considered a safe agent because of its short half-life, adenosine may provoke arrhythmias in the form of AF, bradyarrhythmia and ventricular tachyarrhythmia. Adenosine is also associated with bronchospasm, although this may reflect irritant-induced dyspnoea rather than true obstruction. Adenosine is linked to numerous pathologies relevant to arrhythmia predisposition, including heart failure, obesity, ischaemia and the ageing process itself. This article examines 90 years of experience with adenosine in the light of new European Society of Cardiology guidelines for the management of SVT.
腺苷于1929年被发现，因其负性变时和变传导作用，很快被认为在心律失常治疗中具有潜在作用。20世纪80年代，腺苷作为一种高效药物进入主流应用，用于终止涉及房室结的室上性心动过速（SVT），以及揭示其他室上性心动过速的潜在节律。随后发现腺苷在介入电生理学中也有应用。尽管由于半衰期短被认为是一种安全药物，但腺苷可能引发房颤、缓慢性心律失常和室性快速性心律失常形式的心律失常。腺苷还与支气管痉挛有关，不过这可能反映的是刺激性呼吸困难而非真正的梗阻。腺苷与许多与心律失常易感性相关的病理情况有关，包括心力衰竭、肥胖、缺血以及衰老过程本身。本文根据欧洲心脏病学会关于室上性心动过速管理的新指南，审视了90年来使用腺苷的经验。
