Adenosine test in the diagnosis of unexplained syncope : marker of conducting tissue disease or neurally mediated syncope?

Adenosine test (supine administration of a 20 mg intravenous bolus with electrocardiographic and blood pressure monitoring) has been endorsed by the European Society of Cardiology guidelines on syncope management as an 'experimental' test in the diagnosis of unexplained syncope. The test i...

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Bibliographic Details
Published in:European heart journal 2006-06, Vol.27 (12), p.1396-1400
Main Authors: PARRY, Steve W, NATH, Samiran, BOURKE, John P, BEXTON, Rodney S, KENNY, Rose Anne
Format: Article
Language:English
Subjects:
Adenosine - adverse effects
Adenosine Triphosphate - adverse effects
Biological and medical sciences
Biomarkers
Cardiac dysrhythmias
Cardiology. Vascular system
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Drug Interactions
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Heart
Heart Block - diagnosis
Humans
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Sick Sinus Syndrome - diagnosis
Syncope - etiology
Vasodilator Agents - adverse effects
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Description
Summary:Adenosine test (supine administration of a 20 mg intravenous bolus with electrocardiographic and blood pressure monitoring) has been endorsed by the European Society of Cardiology guidelines on syncope management as an 'experimental' test in the diagnosis of unexplained syncope. The test is quick and cheap, but there is no consensus as to what condition, if any, the adenosine test is exposing, with conducting tissue disease and neurally mediated syncope proposed by various authors. In this article, we review the possible mechanisms underlying a positive adenosine test, its safety, and a comprehensive examination of the literature supporting each of the putative causal diagnoses.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehi844