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.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Szablewski L. Glucose homeostasis and insulin resistance. Sharjah: Betham Science; 2011. p. 68.
Dorner J. Comparative experimental studies on circulatory effect of adrenaline and epinephrine. Arch Kreislaufforsch. 1954;21:88–115.
Clutter WE, Cryer PE. Plasma dose—response studies with noradrenaline and adrenaline in man. Prog Biochem Pharmacol. 1980;17:84–9.
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.
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.
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.
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.
Bell DR. Medical physiology: principles for clinical medicine. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2009. p. 312.
Christensen NJ, Videbaek J. Plasma catecholamines and carbohydrate metabolism in patients with acute myocardial infarction. J Clin Invest. 1974;54:278–86.
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.
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.
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.
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.
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.
Zink J, Sasyniuk BI, Dresel PE. Halothane-epinephrine induced cardiac arrhythmias and the role of the heart rate. Anesthesiology. 1975;43:548–55.
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.
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.
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.
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.
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.
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.
Przybylski J, Chiale PA, Halpern MS, Nau GJ, Elizari MV, Rosenbaum MB. Unmasking of ventricular administration. Circulation. 1980;61:1030–7.
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.
Calkins H, Sousa J, Atassi R. Reversal of antiarrhythmic drug effects by epinephrine: quinidine versus amiodarone. J Am Coll Cardiol. 1992;19:347–52.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Chendran, B. (2019). How to Induce Arrhythmias with Adrenaline. In: Cismaru, G. (eds) Arrhythmia Induction in the EP Lab. Springer, Cham. https://doi.org/10.1007/978-3-319-92729-9_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-92729-9_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-92728-2
Online ISBN: 978-3-319-92729-9
eBook Packages: MedicineMedicine (R0)