Adenosine for the treatment of paroxysmal supraventricular tachycardia under general anesthesia in a patient with wolff-parkinson -white syndrome

Adenosine is an endogenous purine nucleoside natural to all cells in the body. It has been approved recently for use for acute intravenous therapy of paroxysmal supraventricular tachycardia (PSVT) caused by atrioventricular (AV) node reentry or reentry including the AV node and accessory pathways as in a patient with Wolff-Parkinson-White (WPW) syndrome.¹. After an intravenous (IV) bolus of 6 mg, PSVT will convert to a normal sinus rhythm (NSR) in about 60% of patients within 1 minute.² If the initial bolus is unsuccessful, the dysrhythmia will convert to a NSR in a majority of the remaining patients following an additional dose of 12 mg for a cumulative effectiveness of 93%.² Its short half-life may prove useful in PSVT therapy during the perioperative period. A case is described in which adenosine was used to convert a PSVT to NSR in a patient with the WPW syndrome while receiving general anesthesia.