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How to Induce Arrhythmias with Adrenaline

  • Bogdan Chendran
Chapter

Abstract

Adrenaline, also known as epinephrine, is a hormone produced by the adrenal gland that was first isolated in 1895 by the Polish physiologist Napoleon Cybulski. In normal individuals, endogenous plasma concentrations of adrenaline are less than 10 ng/L. This concentration increases tenfold during exercise and 50-fold during physiological or emotional stresses. After adrenaline is given intravenously, a significant increase in plasma concentrations appears within 1 min. In cardiac reanimation, a bolus of adrenaline can produce increased plasma concentrations as 10,000–100,000 ng/L.

References

  1. 1.
    Szablewski L. Glucose homeostasis and insulin resistance. Sharjah: Betham Science; 2011. p. 68.Google Scholar
  2. 2.
    Dorner J. Comparative experimental studies on circulatory effect of adrenaline and epinephrine. Arch Kreislaufforsch. 1954;21:88–115.CrossRefGoogle Scholar
  3. 3.
    Clutter WE, Cryer PE. Plasma dose—response studies with noradrenaline and adrenaline in man. Prog Biochem Pharmacol. 1980;17:84–9.PubMedGoogle Scholar
  4. 4.
    Mazkereth R, PAret G, Ezra D, Aviner S, Peleg E, Rosenthal T, et al. Epinephrine blood concentrations after peripheral bronchial versus endotracheal administration of epinephrine in dogs. Crit Care Med. 1992;20:1582–7.CrossRefGoogle Scholar
  5. 5.
    Raymondos K, Panning B, Leuwer M, Brechelt G, Korte T, Niehaus M, et al. Absorption and hemodynamic effects of airway administration of adrenaline in patients with severe cardiac disease. Ann Intern Med. 2000;132:800–3.CrossRefGoogle Scholar
  6. 6.
    Engelman K, Portnoy B, Portnoy B, Lovenberg W. A sensitive and specific double-isotope derivative method for the determination of catecholamines in biological specimens. Am J Med Sci. 1968;255:259–68.CrossRefGoogle Scholar
  7. 7.
    Goldstein DS, Dionne R, Sweet J, Gracely R, Brewer B, Gregg R, et al. Circulatory, plasma-catecholamine, cortisol, lipid, and psychological responses to a real-life stress (third molar extractions)—effects of diazepam sedation and of inclusion of epinephrine with the local-anesthetic. Psychosom Med. 1982;44:259–72.CrossRefGoogle Scholar
  8. 8.
    Bell DR. Medical physiology: principles for clinical medicine. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2009. p. 312.Google Scholar
  9. 9.
    Christensen NJ, Videbaek J. Plasma catecholamines and carbohydrate metabolism in patients with acute myocardial infarction. J Clin Invest. 1974;54:278–86.CrossRefGoogle Scholar
  10. 10.
    Clutter W, Bier DM, Shah SD, Cryer PE. Epinephrine plasma metabolic clearance rates and physiologic thresholds for metabolic and hemodynamic actions in man. J Clin Invest. 1980;66:94–101.CrossRefGoogle Scholar
  11. 11.
    Toth M, Ziegler M, Sun P, Gresak J, Risbrough V. Impaired conditioned fear response and startle reactivity in epinephrine-deficient mice. Behav Pharmacol. 2013;24:1–9.CrossRefGoogle Scholar
  12. 12.
    Morady F, Nelson SD, Kou WH, Pratley R, Schmaltz S, De Buitleir M, et al. Electro-physiologic effects of epinephrine in humans. J Am Coll Cardiol. 1988;11:1235–44.CrossRefGoogle Scholar
  13. 13.
    Christensen NJ, Alberti KG, Alberti KG, Brandsborg O. Plasma catecholamines and blood substrate concentrations: studies in insulin induced hypoglycemia and after adrenaline infusions. Eur J Clin Investig. 1975;5:415–23.Google Scholar
  14. 14.
    Cohen G, Holland B, Holland B, Sha J, Goldenberg M. Plasma concentrations of epinephrine and norepinephrine during intravenous infusions in man. J Clin Invest. 1959;38:1935–41.CrossRefGoogle Scholar
  15. 15.
    Zink J, Sasyniuk BI, Dresel PE. Halothane-epinephrine induced cardiac arrhythmias and the role of the heart rate. Anesthesiology. 1975;43:548–55.CrossRefGoogle Scholar
  16. 16.
    Lessard Y, Desbrousses S, Paulet G. Cardiac arrhythmia in dogs under the action of adrenaline and difluorodichloromethane. C R Seances Soc Biol Fil. 1977;171:1270–82.PubMedGoogle Scholar
  17. 17.
    Ajioka M, Sugiyama S, Ogawa K, Satake T, Ozawa T. Mechanism of cardiac arrhythmias induceb by epinephrine in dogs with hypokalemia. J Am Coll Cardiol. 1986;8:1373–9.CrossRefGoogle Scholar
  18. 18.
    Darbar D, Smith M, Smith M, Morike K, Morike K, Roden DM. Epinephrine-induced changes in serum potassium and cardiac repolarization and effects of pretreatment with propranolol and diltiazem. Am J Cardiol. 1996;77:1351–5.CrossRefGoogle Scholar
  19. 19.
    Brembilla-Perrot B, Terrier de la Chaise A, Pichene M, Aliot E, Cherrier F, Pernot C. Isoprenaline as an aid to the induction of catecholamine dependent supraventricular tachycardias during programmed stimulation. Br Heart J. 1989;61:348–55.CrossRefGoogle Scholar
  20. 20.
    Stellbrink C, Diem B, Schauerte P, Brehmer K, Schuett H, Hanrath P. Differential effects of atropine preexcitation by vagal stimulation or isoproterenol and isoproterenol on inducibility of atrioventricular nodal reentrant tachycardia. J Interv Card Electrophysiol. 2001;5:463–9.CrossRefGoogle Scholar
  21. 21.
    Cismaru G, Rosu R, Muresan L, Puiu M, Andronache M, Hengan E, et al. The value of adrenaline in the induction of supraventricular tachycardia in the EP lab. Europace. 2014;16:1634–8.CrossRefGoogle Scholar
  22. 22.
    Przybylski J, Chiale PA, Halpern MS, Nau GJ, Elizari MV, Rosenbaum MB. Unmasking of ventricular administration. Circulation. 1980;61:1030–7.CrossRefGoogle Scholar
  23. 23.
    Choi EK, Kumar S, Nagashima K, Lin KY, Barbhaiya CR, Chinitz JS, et al. Better outcome of ablation for sustained outflow-tract ventricular tachycardia when tachycardia is inducible. Europace. 2015;17:1571–9.CrossRefGoogle Scholar
  24. 24.
    Calkins H, Sousa J, Atassi R. Reversal of antiarrhythmic drug effects by epinephrine: quinidine versus amiodarone. J Am Coll Cardiol. 1992;19:347–52.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bogdan Chendran
    • 1
  1. 1.Medicine Physique et Readaptation, Centre Hospitalier Bagnères de BigorreBagnères de BigorreFrance

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