Adenosine preconditioning reduces both pre and postischemic arrhythmias in human myocardium

J Surg Res. 2000 May 15;90(2):191-6. doi: 10.1006/jsre.2000.5889.


Introduction: Consistently, clinical series record supraventricular tachyarrhythmias in approximately 30% of patients following coronary artery bypass surgery (CABG). Ischemic preconditioning and adenosine preconditioning (Ado-PC) decrease postischemia/reperfusion (I/R) myocardial stunning, infarct size, and pharmacologically induced arrhythmias in all species including man. We hypothesized that adenosine preconditioning would decrease spontaneous pre- and postischemic atrial arrhythmias in human myocardium. The purposes of this study were to determine the effect of in vivo and in vitro Ado-PC on atrial arrhythmias.

Methods: Human atrial trabeculae were harvested from CABG patients, placed in organ baths, and paced (1 Hz). Developed force (DF) was recorded during simulated I/R (30/45 min). Prior to I/R, trabeculae were treated with Ado (125 microM) for 5 min (in vitro), or patients were treated with Ado (12 mg iv) 5 min (in vivo) prior to harvest of trabeculae. Contraction frequency >4 Hz (defined as atrial tachyarrhythmias) was recorded in all groups pre- and postischemia.

Results: Control trabeculae exhibited increased tachyarrhythmias pre- and postischemia. In vivo and in vitro Ado-PC suppressed both pre- and postischemic arrhythmias.

Conclusions: Adenosine preconditioning suppresses the frequency of pre- and postischemic tachyarrhythmias against an ischemia/reperfusion insult in human myocardium. This antiarrhythmic effect occurs with both in vitro and in vivo administration of adenosine. Preconditioning with adenosine prior to elective ischemia/reperfusion is a promising strategy of reducing spontaneous atrial arrhythmias in patients undergoing myocardial revascularization.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenosine / administration & dosage*
  • Anti-Arrhythmia Agents / administration & dosage*
  • Coronary Artery Bypass*
  • Electrocardiography
  • Humans
  • In Vitro Techniques
  • Ischemic Preconditioning, Myocardial*
  • Myocardial Contraction
  • Myocardial Ischemia / drug therapy*
  • Myocardial Ischemia / surgery
  • Myocardial Reperfusion Injury / drug therapy
  • Myocardial Reperfusion Injury / surgery
  • Tachycardia, Supraventricular / diagnosis
  • Tachycardia, Supraventricular / drug therapy*


  • Anti-Arrhythmia Agents
  • Adenosine