Correlation of Sinus Node Recovery Time between Single Bolus Adenosine Test and Atrial Overdrive Suppression Test in Patients with and without Sinus Node Dysfunction

• Main Authors: Jih-Min Lin, 林繼敏
• Other Authors: Shoei K. Stephen Huang
• Format: Others
• Language: zh-TW
• Published: 2002
• Online Access: http://ndltd.ncl.edu.tw/handle/48005095333070811258

碩士 === 國立臺灣大學 === 臨床醫學研究所 === 90 === Introduction: The purpose of this study was to correlate the sinus node recovery time between adenosine single bolus method and atrial overdrive suppression test in patients with and without symptomatic sinus dysfunction. Methods & Results: We studied 42 consecutive patients with symptomatic sinus node dysfunction (study group) and 17 age-matched controls (control group) by both atrial overdrive suppression test and single bolus adenosine challenge (0.15 mg/kg). The maximal sinus node recovery time (MSNRT) and corrected maximal SNRT (CMSNRT) were measured at baseline and after autonomic blockade by intravenous atropine (0.04 mg/kg) and metoprolol (0.2 mg/kg). Adenosine-derived CMSNRT (ADN-CMSNRT) was defined as the maximal interval of sinus pause after single bolus adenosine minus basic sinus cycle length. The CMSNRT measured by single dosage adenosine bolus and by atrial overdrive suppression method were strongly correlated to each other either before or after autonomic blockade (r=0.71 before and r=0.75 after autonomic blockade, both p <0.0001) in the study group, but not in the control group (r=0.089 before and r=-0.183 after autonomic blockade, both p >0.05). With a cut-off value of ADN-CMSNRT ≧380 msec at baseline or ≧600 msec after autonomic blockade (1.65 standard deviation above mean from control group), the diagnostic sensitivity, specificity, and predictive accuracy of single bolus adenosine for sinus node dysfunction were 62%, 94% and 71% at baseline and 45%, 94% and 59% after autonomic blockade respectively. Conclusions: The sinus node recovery time by single bolus adenosine is highly correlated with the atrial overdrive suppression test in patients with sinus node dysfunction. This noninvasive pharmacological test may be preferable to the conventional atrial pacing for patients with sinus node dysfunction.