adenosine

Adenosine is used to treat certain types of irregular heart rhythms. It also can be used during a stress test to diagnose certain heart problems, such as coronary artery disease, heart failure, or heart rhythm problems.

Adenosine works by binding (attaching) to certain receptors in your heart that are responsible for controlling the rhythm of your heartbeat. When adenosine binds to these receptors, it slows down your heart rate. For stress tests, adenosine works by opening your blood vessels. This helps raise bloodflow and allows your provider to see problems with your blood vessels on imaging.

To treat irregular heart rhythms, adenosine is typically given in the hospital as a fast injection through the veins (intravenously or IV). It's immediately followed by a normal saline injection ("flush"), which helps adenosine reach your heart very quickly. This is needed because adenosine doesn't last very long in the body before it gets broken down. For heart stress tests, adenosine is also given IV, but at a slower speed over about 6 minutes. Stress tests can be performed at a provider's office, clinic, or hospital.

For the treatment of irregular heart rhythms, the typical starting dose for adults and children weighing at least 110 lbs is 6 mg given IV over 1 to 2 seconds. If the first dose doesn't treat the irregular heartbeat, a 12 mg dose is usually given right after, which can be repeated again if needed. The dose for children weighing less than 110 lbs is based on their body weight. Treatment generally follows the same order of steps as for adults (higher doses given after the first if the irregular heart rhythm hasn't resolved yet). For stress testing, the typical dose in adults is based on body weight (140 mcg/kg of body weight per minute) given through the vein over 6 minutes.