Induction of Atrial Fibrillation with Adenosine during a Transesophageal Electrophysiology Study to Risk Stratify a Patient with Asymptomatic Ventricular Preexcitation Article

Full Text via DOI: 10.1111/j.1747-0803.2012.00682.x PMID: 22676712 Web of Science: 000326501000001

Cited authors

  • Hoyt, Walter J., Jr.; Thomas, Patricia E.; Snyder, Christopher S.


  • An asymptomatic adolescent male athlete was incidentally found to have ventricular preexcitation on electrocardiogram during a sports preparticipation physical. A transesophageal electrophysiology study (TEEPS) was performed after an exercise stress test failed to delineate the patient's risk of sudden cardiac death. The TEEPS was favored in this case over a transvenous electrophysiology study due to reduced invasiveness. The goal of the TEEPS was to place the patient into atrial fibrillation (AFib) and evaluate the shortest preexcited RR interval during AFib, thereby assessing the risk of his accessory pathway. Conventional pacing modalities were unable to induce AFib. During atrial burst pacing, adenosine was then administered, which successfully induced AFib. This case highlights adenosine's potential to induce atrial fibrillation during transesophageal electrophysiology studies when atrial pacing alone was unable to do so.

Publication date

  • 2013

Published in

International Standard Serial Number (ISSN)

  • 1747-079X

Start page

  • E99

End page

  • E101


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