Efstathia Andrikopoulou1,2, Charity J Morgan3, Lizbeth Brice3, Navkaranbir S Bajaj3,4, Harish Doppalapudi3,5, Ami E Iskandrian3, Fadi G Hage3,5. 1. University of Alabama at Birmingham, Birmingham, AL, USA. eandrikopoulou@bwh.harvard.edu. 2. Brigham and Women's Hospital, Boston, MA, USA. eandrikopoulou@bwh.harvard.edu. 3. University of Alabama at Birmingham, Birmingham, AL, USA. 4. Brigham and Women's Hospital, Boston, MA, USA. 5. Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
Abstract
BACKGROUND: Adenosine or regadenoson are often used with pharmacologic stress testing. Adenosine may trigger atrioventricular block (AVB). Despite its higher selectivity, regadenoson has also been associated with AVB. We studied the incidence of de novo AVB with these agents. METHODS: A comprehensive search of SCOPUS was performed from inception to March 2016. Studies of at least 10 patients, using adenosine and/or regadenoson with SPECT-MPI, reporting rates of AVB were selected for further review. RESULTS: Thirty four studies were pooled including 22,957 patients. Adenosine was used in 21 studies and regadenoson in 15. Both were administered in two studies. The estimated incidence of overall and high-grade AVB was 3.81% (95% CI 1.99%-6.19%) and 1.93% (95% CI 0.77%-3.59%), respectively. The incidence of AVB (8.58%; 95% CI 5.55%-12.21% vs 0.30%; 95% CI 0.04%-0.82%, respectively, P < .001) and high-grade AVB (5.21%; 95% CI 2.81%-8.30% vs 0.05%; 95% CI < .001%-0.19% respectively, P < .001) were higher with adenosine compared to regadenoson. CONCLUSION: AVB is seen in about 4% of patients undergoing vasodilator stress test. Both overall and high-grade AVB are more frequent with adenosine compared to regadenoson.
BACKGROUND:Adenosine or regadenoson are often used with pharmacologic stress testing. Adenosine may trigger atrioventricular block (AVB). Despite its higher selectivity, regadenoson has also been associated with AVB. We studied the incidence of de novo AVB with these agents. METHODS: A comprehensive search of SCOPUS was performed from inception to March 2016. Studies of at least 10 patients, using adenosine and/or regadenoson with SPECT-MPI, reporting rates of AVB were selected for further review. RESULTS: Thirty four studies were pooled including 22,957 patients. Adenosine was used in 21 studies and regadenoson in 15. Both were administered in two studies. The estimated incidence of overall and high-grade AVB was 3.81% (95% CI 1.99%-6.19%) and 1.93% (95% CI 0.77%-3.59%), respectively. The incidence of AVB (8.58%; 95% CI 5.55%-12.21% vs 0.30%; 95% CI 0.04%-0.82%, respectively, P < .001) and high-grade AVB (5.21%; 95% CI 2.81%-8.30% vs 0.05%; 95% CI < .001%-0.19% respectively, P < .001) were higher with adenosine compared to regadenoson. CONCLUSION: AVB is seen in about 4% of patients undergoing vasodilator stress test. Both overall and high-grade AVB are more frequent with adenosine compared to regadenoson.
Authors: Robert C Hendel; Timothy M Bateman; Manuel D Cerqueira; Ami E Iskandrian; Jeffrey A Leppo; Brent Blackburn; John J Mahmarian Journal: J Am Coll Cardiol Date: 2005-11-09 Impact factor: 24.094
Authors: Milena J Henzlova; W Lane Duvall; Andrew J Einstein; Mark I Travin; Hein J Verberne Journal: J Nucl Cardiol Date: 2016-06 Impact factor: 5.952
Authors: Deborah H Kwon; Manuel D Cerqueira; Ron Young; Penny Houghtaling; Elizabeth Lieber; Venu Menon; Richard C Brunken; Wael A Jaber Journal: J Nucl Cardiol Date: 2010-04-23 Impact factor: 5.952
Authors: Imad M Tleyjeh; Zakariya Kashour; Oweida AlDosary; Muhammad Riaz; Haytham Tlayjeh; Musa A Garbati; Rana Tleyjeh; Mouaz H Al-Mallah; M Rizwan Sohail; Dana Gerberi; Aref A Bin Abdulhak; John R Giudicessi; Michael J Ackerman; Tarek Kashour Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-11-02
Authors: Jose V Monmeneu Menadas; Maria P García Gonzalez; Maria P Lopez-Lereu; Laura Higueras Ortega; Alicia M Maceira Gonzalez Journal: Int J Cardiovasc Imaging Date: 2021-07-31 Impact factor: 2.357