{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:43:34Z","timestamp":1753879414117,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000895","name":"St. Jude Medical Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000895","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000040"],"award-info":[{"award-number":["UL1 TR000040"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Relative contraindications to adenosine use have included heart transplant and dipyridamole. We previously demonstrated the safety and efficacy of adenosine\u2010induced atrioventricular (AV) block in healthy young heart transplant recipients while suspending dipyridamole therapy (dual antiplatelet agent). This prospective follow\u2010up study evaluated the safety and efficacy of adenosine use in the same cohort of heart transplant recipients while on dipyridamole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adenosine was incrementally dosed until AV block occurred (maximum 200\u00a0mcg\/kg up to 12\u00a0mg). The primary outcome was clinically significant asystole (\u226512\u00a0seconds). Secondary outcomes included maximal adenosine dose, AV block duration, dysrhythmias, and clinical symptoms. Outcomes were compared to the parent study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty of 39 eligible patients (5\u201024\u00a0years) were tested. No patient (0%, CI 0%\u20108%) experienced clinically significant asystole. AV block occurred in 29\/30 patients (97%, CI 86%\u2010100%). The median dose causing AV block was 50mcg\/kg (vs 100\u00a0mcg\/kg off dipyridamole; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.011). Seventeen patients (57%, CI 39%\u201072%) required less adenosine to achieve AV block on dipyridamole; six (20%) required more. AV block occurred at doses \u226525\u00a0mcg\/kg in all patients. In pairwise comparison to prior testing off dipyridamole, no significant change occurred in AV block duration, frequency of cardiac ectopy, or incidence of reported symptoms. No atrial fibrillation\/flutter occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AV block often occurs at twofold lower adenosine doses in healthy young heart transplant recipients taking oral dipyridamole, compared with previous testing of this cohort off dipyridamole. Results suggest that initial dosing of 25\u00a0mcg\/kg (maximum 0.8\u00a0mg) with stepwise escalation poses low risk of prolonged asystole on dipyridamole.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13689","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T02:18:32Z","timestamp":1583893112000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of dipyridamole on adenosine dosing in pediatric and young adult patients after heart transplantation"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-4095","authenticated-orcid":false,"given":"Michael B.","family":"Satzer","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan 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