Adenosine-induced atrial fibrillation during pharmacologic stress testing: Report of eight cases and review of the literature

Adenosine-induced atrial fibrillation has been described in the setting of treatment of supraventricular tachycardia, but has been rarely reported during adenosine infusion for pharmacologic stress testing. We present 8 patients who developed atrial fibrillation during adenosine stress testing. The incidence of this arrhythmia was 0.41% in our laboratory. Atrial fibrillation was often preceded by frequent atrial premature beats and/or AV block, and the duration ranged from 15 seconds to 6 hours. All patients converted spontaneously to normal sinus rhythm. Atrial fibrillation is a relatively rare arrhythmic complication of adenosine infusion, and can be managed expectantly, without need of cardioversion.