Limitations of adenosine testing
The rate of long term clinical cure of atrial flutter in most modern
series, including the current one exceeds 98%. This context makes the
observed failure rate of early adenosine testing of 2.3% in our series
and the 1.2% failure rate recorded by Morales et al highly significant.
With such a high rate success easily available, acceptance of anything
less than certainty in the permanence of block would be unsatisfactory.
The regime that we used does not meet this standard; a higher dosage, or
a dosage regime tailored to the patient’s weight or to the effect on
atrioventricular conduction would be worth evaluating.