Unmasking Adenosine: The Purinergic Signalling Molecule Critical to Arrhythmia Pathophysiology and Management (2024)

1. Brugada J, Katritsis D, Arbelo E et al. 2019 ESC guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 2019;00:1–65. doi:10.1093/eurheartj/ehz467. [PubMed] [CrossRef] [Google Scholar]

2. Lerman BB, Markowitz SM, Cheung JW et al. Supraventricular tachycardia: mechanistic insights deduced from adenosine. Circ Arrhythm Electrophysiol. 2018;11:e006953. doi:10.1161/CIRCEP.118.006953. [PubMed] [CrossRef] [Google Scholar]

3. Mustafa SJ, Morrison RR, Teng B Adenosine receptors and the heart: role in regulation of coronary blood flow and cardiac electrophysiology. Handb Exp Pharmacol. 2009. pp. 161–88. [PMC free article] [PubMed] [CrossRef]

4. Drury AN, Szent-Györgyi A. The physiological activity of adenine compounds with especial reference to their action upon the mammalian heart. J Physiol. 1929;68:213–37. doi:10.1113/jphysiol.1929.sp002608. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Lohmann K. On the pyrophosphate fraction in muscle. Naturwissenschaften. 1929;17:624–5. doi:10.1007/BF01506215. [in German] [CrossRef] [Google Scholar]

6. Lewis T, Drury A, Iliescu C. A demonstration of circus movement in clinical flutter of the auricles. Heart. 1921;8:341–59. [Google Scholar]

7. Lewis T, Drury A, Bulger H. Observations upon flutter and fibrillation. VII. The effect of vagal stimulation. Heart. 1921;8:141–69. [Google Scholar]

8. Lewis T, Drury AN, Iliescu CC et al. The manner in which quinidine sulphate acts in auricular fibrillation. Br Med J. 1921;2:514–5. doi:10.1136/bmj.2.3170.514. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

9. Grace AA, Matthews GDK. Quinidine rebooted: contemporary approaches to multichannel blockade. JACC Clin Electrophysiol. 2019;5:383–6. doi:10.1016/j.jacep.2019.01.015. [PubMed] [CrossRef] [Google Scholar]

10. Honey RM, Ritchie WT, Thomson WAR. The action of adenosine upon the human heart. QJM. 1930;os-23:485–9. doi:10.1093/qjmed/os-23.92.485. [CrossRef] [Google Scholar]

11. Deaglio S, Dwyer KM, Gao W et al. Adenosine generation catalyzed by CD39 and CD73 expressed on regulatory T cells mediates immune suppression. J Exp Med. 2007;204:1257–65. doi:10.1084/jem.20062512. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

12. Shen W-K, Kurachi Y. Mechanisms of adenosine-mediated actions on cellular and clinical cardiac electrophysiology. Mayo Clin Proc. 1995;70:274–91. doi:10.4065/70.3.274. [PubMed] [CrossRef] [Google Scholar]

13. Olsson LG, Swedberg K, Ducharme A et al. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) program. J A. m Coll Cardiol. 2006;47:1997–2004. doi:10.1016/j.jacc.2006.01.060. [PubMed] [CrossRef] [Google Scholar]

14. Berne RM. Cardiac nucleotides in hypoxia: possible role in regulation of coronary blood flow. Am J Physiol. 1963;204:317–2. doi:10.1152/ajplegacy.1963.204.2.317. [PubMed] [CrossRef] [Google Scholar]

15. Rubio R, Wiedmeier VT, Berne RM. Relationship between coronary flow and adenosine production and release. J Mol Cell Cardiol. 1974;6:561–6. doi:10.1016/0022-2828(74)90036-4. [PubMed] [CrossRef] [Google Scholar]

16. Frøbert O, Haink G, Simonsen U et al. Adenosine concentration in the porcine coronary artery wall and A2A receptor involvement in hypoxia-induced vasodilatation. J Physiol. 2006;570:375–84. doi:10.1113/jphysiol.2005.100115. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

17. Shryock JC, Snowdy S, Baraldi PG et al. A2A-adenosine receptor reserve for coronary vasodilation. Circulation. 1998;98:711–8. doi:10.1161/01.cir.98.7.711. [PubMed] [CrossRef] [Google Scholar]

18. Schrader J, Baumann G, Gerlach E. Adenosine as inhibitor of myocardial effects of catecholamines. Pflugers Arch. 1977;372:29–35. doi:10.1007/bf00582203. [PubMed] [CrossRef] [Google Scholar]

19. Rockoff JB, Dobson JG. Inhibition by adenosine of catecholamine-induced increase in rat atrial contractility. Am J Physiol. 1980;239:H365–70. doi:10.1152/ajpheart.1980.239.3.H365. [PubMed] [CrossRef] [Google Scholar]

20. Clemo HF, Belardinelli L. Effect of adenosine on atrioventricular conduction. I: site and characterization of adenosine action in the guinea pig atrioventricular node. Circ Res. 1986;59:427–36. doi:10.1161/01.RES.59.4.427. [PubMed] [CrossRef] [Google Scholar]

21. Ragazzi E, Wu SN, Shryock J et al. Electrophysiological and receptor binding studies to assess activation of the cardiac adenosine receptor by adenine nucleotides. Circ Res. 1991;68:1035–44. doi:10.1161/01.res.68.4.1035. [PubMed] [CrossRef] [Google Scholar]

22. Li N, Csepe TA, Hansen BJ et al. Adenosine-induced atrial fibrillation: localized reentrant drivers in lateral right atria due to heterogeneous expression of adenosine A1 receptors and GIRK4 subunits in the human heart. Circulation. 2016;134:486–98. doi:10.1161/CIRCULATIONAHA.115.021165. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

23. Ng GA, Martin W, Rankin AC. Imaging of adenosine bolus transit following intravenous administration: insights into antiarrhythmic efficacy. Heart. 1999;82:163–9. doi:10.1136/hrt.82.2.163. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

24. Cabalag MS, Taylor DM, Knott JC et al. Recent caffeine ingestion reduces adenosine efficacy in the treatment of paroxysmal supraventricular tachycardia. Acad Emerg Med. 2010;17:44–9. doi:10.1111/j.1553-2712.2009.00616.x. [PubMed] [CrossRef] [Google Scholar]

25. Bunag RD, Douglas CR, Imai S et al. Influence of a pyrimidopyrimidine derivative on deamination of adenosine by blood. Circ Res. 1964;15:83–8. doi:10.1161/01.res.15.1.83. [PubMed] [CrossRef] [Google Scholar]

26. Harker LA, Kadatz RA. Mechanism of action of dipyridamole. Thromb Res Suppl. 1983;4:39–46. doi:10.1016/0049-3848(83)90356-0. [PubMed] [CrossRef] [Google Scholar]

27. Thorn JA, Jarvis SM. Adenosine transporters. Gen Pharmacol. 1996;27:613–20. doi:10.1016/0306-3623(95)02053-5. [PubMed] [CrossRef] [Google Scholar]

28. Kurachi Y, Nakajima T, Sugimoto T. On the mechanism of activation of muscarinic K+ channels by adenosine in isolated atrial cells: involvement of GTP-binding proteins. Pflugers Arch. 1986;407:264–74. doi:10.1007/bf00585301. [PubMed] [CrossRef] [Google Scholar]

29. Ito H, Tung RT, Sugimoto T et al. On the mechanism of G protein beta gamma subunit activation of the muscarinic K+ channel in guinea pig atrial cell membrane. Comparison with the ATP-sensitive K+ channel. J Gen Physiol. 1992;99:961–83. doi:10.1085/jgp.99.6.961. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

30. Isenberg G, Belardinelli L. Ionic basis for the antagonism between adenosine and isoproterenol on isolated mammalian ventricular myocytes. Circ Res. 1984;55:309–25. doi:10.1161/01.res.55.3.309. [PubMed] [CrossRef] [Google Scholar]

31. Baker SP, Scammells PJ, Belardinelli L. Differential A(1)-adenosine receptor reserve for inhibition of cyclic AMP accumulation and G-protein activation in DDT(1) MF–2 cells. Br J Pharmacol. 2000;130:1156–64. doi:10.1038/sj.bjp.0703405. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

32. Srinivas M, Shryock JC, Dennis DM et al. Differential A1 adenosine receptor reserve for two actions of adenosine on guinea pig atrial myocytes. Mol Pharmacol. 1997;52:683–91. doi:10.1124/mol.52.4.683. [PubMed] [CrossRef] [Google Scholar]

33. Belardinelli L, Linden J, Berne RM. The cardiac effects of adenosine. Prog Cardiovasc Dis. 1989;32:73–97. doi:10.1016/0033-0620(89)90015-7. [PubMed] [CrossRef] [Google Scholar]

34. West GA, Belardinelli L. Correlation of sinus slowing and hyperpolarization caused by adenosine in sinus node. Pflugers Arch. 1985;403:75–81. doi:10.1007/bf00583285. [PubMed] [CrossRef] [Google Scholar]

35. Hata T, Noda T, Nishimura M, Watanabe Y. The role of Ca2+ release from sarcoplasmic reticulum in the regulation of sinoatrial node automaticity. Heart Vessels. 1996;11:234–41. [PubMed] [Google Scholar]

36. Kabell G, Buchanan LV, Gibson JK et al. Effects of adenosine on atrial refractoriness and arrhythmias. Cardiovasc Res. 1994;28:1385–9. doi:10.1093/cvr/28.9.1385. [PubMed] [CrossRef] [Google Scholar]

37. Rosen MR, Danilo P, Weiss RM. Actions of adenosine on normal and abnormal impulse initiation in canine ventricle. Am J Physiol. 1983;244:H715–21. doi:10.1152/ajpheart.1983.244.5.H715. [PubMed] [CrossRef] [Google Scholar]

38. Lerman BB, Wesley RC, DiMarco JP et al. Antiadrenergic effects of adenosine on His-Purkinje automaticity. Evidence for accentuated antagonism. J Clin Invest. 1988;82:2127–35. doi:10.1172/JCI113834. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

39. Raberger G, Kraupp O, Stühlinger W et al. The effects of an intracoronary infusion of adenosine on cardiac performance, blood supply and on myocardial metabolism in dogs. Pflugers Arch. 1970;317:20–34. doi:10.1007/bf00586697. [PubMed] [CrossRef] [Google Scholar]

40. Pelleg A, Hurt CM. Mechanism of action of ATP on canine pulmonary vagal C fibre nerve terminals. J Physiol. 1996;490:265–75. doi:10.1113/jphysiol.1996.sp021142. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

41. Pelleg A, Katchanov G, Xu J. Autonomic neural control of cardiac function: modulation by adenosine and adenosine 5’-triphosphate. Am J Cardiol. 1997;79:11–4. doi:10.1016/s0002-9149(9x)00257-5. [PubMed] [CrossRef] [Google Scholar]

42. Brubaker S, Long B, Koyfman A. Alternative treatment options for atrioventricular-nodal-reentry tachycardia: an emergency medicine review. J Emerg Med. 2018;54:198–206. doi:10.1016/j.jemermed.2017.10.003. [PubMed] [CrossRef] [Google Scholar]

43. Appelboam A, Reuben A, Mann C et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015;386:1747–53. doi:10.1016/S0140-6736(15)61485-4. [PubMed] [CrossRef] [Google Scholar]

44. Somló E. Adenosine triphosphate in paroxysmal tachycardia. Lancet. 1955;265:1125. doi:10.1016/S0140-6736(55)90620-6. [CrossRef] [Google Scholar]

45. DiMarco JP, Sellers TD, Berne RM et al. Adenosine: electrophysiologic effects and therapeutic use for terminating paroxysmal supraventricular tachycardia. Circulation. 1983;68:1254–63. doi:10.1161/01.cir.68.6.1254. [PubMed] [CrossRef] [Google Scholar]

46. DiMarco JP, Sellers TD, Lerman BB et al. Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias. J Am Coll Cardiol. 1985;6:417–25. doi:10.1016/s0735-1097(85)80181-9. [PubMed] [CrossRef] [Google Scholar]

47. Greco R, Musto B, Arienzo V et al. Treatment of paroxysmal supraventricular tachycardia in infancy with digitalis, adenosine-5’-triphosphate, and verapamil: a comparative study. Circulation. 1982;66:504–8. doi:10.1161/01.cir.66.3.504. [PubMed] [CrossRef] [Google Scholar]

48. Belhassen B, Viskin S. What is the drug of choice for the acute termination of paroxysmal supraventricular tachycardia: verapamil, adenosine triphosphate, or adenosine? Pacing Clin Electrophysiol. 1993;16:1735–41. doi:10.1111/j.1540-8159.1993.tb01044.x. [PubMed] [CrossRef] [Google Scholar]

49. Belhassen B. Close look at ECG tracing after termination of supraventricular tachycardia with adenosine. Isr Med Assoc J. 2006;8:361–2. [PubMed] [Google Scholar]

50. Viskin S, Fish R, Glick A et al. The adenosine triphosphate test: a bedside diagnostic tool for identifying the mechanism of supraventricular tachycardia in patients with palpitations. J Am Coll Cardiol. 2001;38:173–7. doi:10.1016/s0735-1097(01)01336-5. [PubMed] [CrossRef] [Google Scholar]

51. Alabed S, Providência R, Chico TJA. Cochrane corner: adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Heart. 2018;104:1993–4. doi:10.1136/heartjnl-2017-312909. [PubMed] [CrossRef] [Google Scholar]

52. Honarbakhsh S, Baker V, Kirkby C et al. Safety and efficacy of paramedic treatment of regular supraventricular tachycardia: a randomised controlled trial. Heart. 2017;103:1413–8. doi:10.1136/heartjnl-2016-309968. [PubMed] [CrossRef] [Google Scholar]

53. Dewland TA, Oesterle A, Stein J et al. Health care utilization among adenosine-sensitive supraventricular tachycardia patients presenting to the emergency department. J Interv Card Electrophysiol. 2017;49:103–9. doi:10.1007/s10840-017-0259-1. [PubMed] [CrossRef] [Google Scholar]

54. Dadi G, Fink D, Weiser G. High-dose adenosine for refractory supraventricular tachycardia: a case report and literature review. Cardiol Young. 2017;27:981–4. doi:10.1017/S1047951116002626. [PubMed] [CrossRef] [Google Scholar]

55. Lewis J, Arora G, Tudorascu DL et al. Acute management of refractory and unstable pediatric supraventricular tachycardia. J Pediatr. 2017;181:177–82. doi:10.1016/j.jpeds.2016.10.051. [PubMed] [CrossRef] [Google Scholar]

56. Robles Velasco P, Monedero Sánchez I, Rubio Caballero A et al. Adenosine administration in supraventricular tachycardia. Neth Heart J. 2018;26:221–2. doi:10.1007/s12471-017-1033-9. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

57. Kunnumpuram GK, Patel A. Adenosine-induced worsening of supraventricular tachycardia. BMJ Case Rep. 2012;2012 doi:10.1136/bcr-2012-007821. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

58. Gottlieb M, Gore K, Gore SR. Is adenosine or an intravenous calcium channel blocker more effective for treating supraventricular tachycardia? Ann Emerg Med. 2018;72:553–5. doi:10.1016/j.annemergmed.2017.11.024. [PubMed] [CrossRef] [Google Scholar]

59. Garratt CJ, Griffith MJ, O’Nunain S et al. Effects of intravenous adenosine on antegrade refractoriness of accessory atrioventricular connections. Circulation. 1991;84:1962–8. doi:10.1161/01.cir.84.5.1962. [PubMed] [CrossRef] [Google Scholar]

60. Waldo AL. Atrial fibrillation and atrial flutter: two sides of the same coin! Int J Cardiol. 2017;240:251–2. doi:10.1016/j.ijcard.2017.02.146. [PubMed] [CrossRef] [Google Scholar]

61. Waldo AL. More musing about the inter-relationships of atrial fibrillation and atrial flutter and their clinical implications. Circ Arrhythm Electrophysiol. 2013;6:453–4. doi:10.1161/CIRCEP.113.000507. [CrossRef] [Google Scholar]

62. Ortiz J, Niwano S, Abe H et al. Mapping the conversion of atrial flutter to atrial fibrillation and atrial fibrillation to atrial flutter. Insights into mechanisms. Circ Res. 1994;74:882–94. doi:10.1161/01.res.74.5.882. [PubMed] [CrossRef] [Google Scholar]

63. Gourraud J-B, Andrade JG, Macle L et al. Pharmacological tests in atrial fibrillation ablation. Arrhythmia Electrophysiol Rev. 2016;5:170–6. doi:10.15420/aer.2016:27:2. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

64. Macle L, Khairy P, Weerasooriya R et al. Adenosine-guided pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation: an international, multicentre, randomised superiority trial. Lancet. 2015;386:672–9. doi:10.1016/S0140-6736(15)60026-5. [PubMed] [CrossRef] [Google Scholar]

65. Kobori A, Shizuta S, Inoue K et al. Adenosine triphosphate-guided pulmonary vein isolation for atrial fibrillation: the UNmasking Dormant Electrical Reconduction by Adenosine TriPhosphate (UNDER-ATP) trial. Eur Heart J. 2015;36:3276–87. doi:10.1093/eurheartj/ehv457. [PubMed] [CrossRef] [Google Scholar]

66. Ghanbari H, Jani R, Hussain-Amin A et al. Role of adenosine after antral pulmonary vein isolation of paroxysmal atrial fibrillation: a randomized controlled trial. Heart Rhythm. 2016;13:407–15. doi:10.1016/j.hrthm.2015.10.016. [PubMed] [CrossRef] [Google Scholar]

67. Morales GX, Macle L, Khairy P et al. Adenosine testing in atrial flutter ablation: unmasking of dormant conduction across the cavotricuspid isthmus and risk of recurrence. J Cardiovasc Electrophysiol. 2013;24:995–1001. doi:10.1111/jce.12174. [PubMed] [CrossRef] [Google Scholar]

68. Lehrmann H, Weber R, Park C et al. ‘Dormant transisthmus conduction’ revealed by adenosine after cavotricuspid isthmus ablation. Heart Rhythm. 2012;9:1942–6. doi:10.1016/j.hrthm.2012.08.020. [PubMed] [CrossRef] [Google Scholar]

69. Morales G, Darrat YH, Lellouche N et al. Use of adenosine to shorten the post ablation waiting period for cavotricuspid isthmus-dependent atrial flutter. J Cardiovasc Electrophysiol. 2017;28:876–81. doi:10.1111/jce.13233. [PubMed] [CrossRef] [Google Scholar]

70. Dobrzynski H, Marples DD, Musa H et al. Distribution of the muscarinic K+ channel proteins Kir3.1 and Kir3.4 in the ventricle, atrium, and sinoatrial node of heart. J Histochem Cytochem. 2001;49:1221–34. doi:10.1177/002215540104901004. [PubMed] [CrossRef] [Google Scholar]

71. Yang Y, Yang Y, Liang B et al. Identification of a Kir3.4 mutation in congenital long QT syndrome. Am J Hum Genet. 2010;86:872–80. doi:10.1016/j.ajhg.2010.04.017. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

72. Liang B, Nissen JD, Laursen M et al. G-protein-coupled inward rectifier potassium current contributes to ventricular repolarization. Cardiovasc Res. 2014;101:175–84. doi:10.1093/cvr/cvt240. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

73. Dobson JG. Reduction by adenosine of the isoproterenol-induced increase in cyclic adenosine 3’,5’-monophosphate formation and glycogen phosphorylase activity in rat heart muscle. Circ Res. 1978;43:785–92. doi:10.1161/01.res.43.5.785. [PubMed] [CrossRef] [Google Scholar]

74. Biaggioni I, Olafsson B, Robertson RM et al. Cardiovascular and respiratory effects of adenosine in conscious man. Evidence for chemoreceptor activation. Circ Res. 1987;61:779–86. doi:10.1161/01.res.61.6.779. [PubMed] [CrossRef] [Google Scholar]

75. Liu CF, Ip JE, Lin AC et al. Mechanistic heterogeneity of junctional ectopic tachycardia in adults. Pacing Clin Electrophysiol PACE. 2013;36:e7–10. doi:10.1111/j.1540-8159.2011.03214.x. [PubMed] [CrossRef] [Google Scholar]

76. Song Y, Thedford S, Lerman BB et al. Adenosine-sensitive afterdepolarizations and triggered activity in guinea pig ventricular myocytes. Circ Res. 1992;70:743–53. doi:10.1161/01.res.70.4.743. [PubMed] [CrossRef] [Google Scholar]

77. Watt AH. Sick sinus syndrome: an adenosine-mediated disease. Lancet. 1985;1:786–88. doi:10.1016/s0140-6736(85)91449-7. [PubMed] [CrossRef] [Google Scholar]

78. Lai WT, Lai HM, Lin CT et al. Is sick sinus syndrome an adenosine-mediated disease? Effects of intravenous aminophylline on sick sinus node function after pharmacologic autonomic blockade. Chest. 1991;99:887–91. doi:10.1378/chest.99.4.887. [PubMed] [CrossRef] [Google Scholar]

79. Fragakis N, Antoniadis AP, Korantzopoulos P et al. Sinus nodal response to adenosine relates to the severity of sinus node dysfunction. Europace. 2012;14:859–64. doi:10.1093/europace/eur399. [PubMed] [CrossRef] [Google Scholar]

80. Benedini G, Cuccia C, Bolognesi R et al. Value of purinic compounds in assessing sinus node dysfunction in man: a new diagnostic method. Eur Heart J. 1984;5:394–403. doi:10.1093/oxfordjournals.eurheartj.a061673. [PubMed] [CrossRef] [Google Scholar]

81. Saito D, Yamanari H, Matsubara K et al. Intravenous injection of adenosine triphosphate for assessing sinus node dysfunction in patients with sick sinus syndrome. Arzneimittelforschung. 1993;43:1313–6. [PubMed] [Google Scholar]

82. Nicol M, Deblaise J, Choussat R et al. Side effects of ticagrelor: sinus node dysfunction with ventricular pause. Int J Cardiol. 2015;191:56–7. doi:10.1016/j.ijcard.2015.04.198. [PubMed] [CrossRef] [Google Scholar]

83. Mittal S, Stein KM, Markowitz SM et al. Induction of neurally mediated syncope with adenosine. Circulation. 1999;99:1318–24. doi:10.1161/01.cir.99.10.1318. [PubMed] [CrossRef] [Google Scholar]

84. Mittal S, Stein KM, Markowitz SM et al. Single-stage adenosine tilt testing in patients with unexplained syncope. J Cardiovasc Electrophysiol. 2004;15:637–40. doi:10.1046/j.1540-8167.2004.03556.x. [PubMed] [CrossRef] [Google Scholar]

85. Flammang D, Benditt DG, Church TR et al. Adenosine 5’-triphosphate test in the management of patients with syncope. Am J Ther. 2016;23:e1347–52. doi:10.1097/MJT.0000000000000176. [PubMed] [CrossRef] [Google Scholar]

86. Calvo-Romero JM, Pérez-Miranda M, Bureo-Dacal P. Syncope in acute pulmonary embolism. Eur J Emerg Med. 2004;11:208–9. doi:10.10.1097/01.mej.0000136696.49343.8f. [PubMed] [CrossRef] [Google Scholar]

87. Prandoni P, Lensing AWA, Prins MH et al. Prevalence of pulmonary embolism among patients hospitalized for syncope. N Engl J Med. 2016;375:1524–31. doi:10.1056/NEJMoa1602172. [PubMed] [CrossRef] [Google Scholar]

88. Pelleg A, Schulman ES, Barnes PJ. Adenosine 5’-triphosphate’s role in bradycardia and syncope associated with pulmonary embolism. Respir Res. 2018;19:142. doi:10.1186/s12931-018-0848-2. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

89. GBD 2015 Obesity Collaborators. Afshin A, Forouzanfar MH et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27. doi:10.1056/NEJMoa1614362. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

90. von Lengerke T, Krauth C. Economic costs of adult obesity: a review of recent European studies with a focus on subgroup-specific costs. Maturitas. 2011;69:220–9. doi:10.1016/j.maturitas.2011.04.005. [PubMed] [CrossRef] [Google Scholar]

91. Wang TJ, Parise H, Levy D et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471–7. doi:10.1001/jama.292.20.2471. [PubMed] [CrossRef] [Google Scholar]

92. Jouven X, Desnos M, Guerot C, Ducimetière P. Predicting sudden death in the population: the Paris Prospective Study I. Circulation. 1999;99:1978–83. doi:10.1161/01.CIR.99.15.1978. [PubMed] [CrossRef] [Google Scholar]

93. Noheria A, Teodorescu C, Uy-Evanado A et al. Distinctive profile of sudden cardiac arrest in middle-aged vs older adults: a community-based study. Int J Cardiol. 2013;168:3495–9. doi:10.1016/j.ijcard.2013.04.207. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

94. Pietrasik G, Goldenberg I, McNitt S et al. Obesity as a risk factor for sustained ventricular tachyarrhythmias in MADIT II patients. J Cardiovasc Electrophysiol. 2007;18:181–4. doi:10.1111/j.1540-8167.2006.00680.x. [PubMed] [CrossRef] [Google Scholar]

95. Munger TM, Dong Y-X, Masaki M et al. Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation. J Am Coll Cardiol. 2012;60:851–60. doi:10.1016/j.jacc.2012.03.042. [PubMed] [CrossRef] [Google Scholar]

96. El-Gamal A, Gallagher D, Nawras A et al. Effects of obesity on QT, RR, and QTc intervals. Am J Cardiol. 1995;75:956–9. doi:10.1016/S0002-9149(99)80700-0. [PubMed] [CrossRef] [Google Scholar]

97. Lalani AP, Kanna B, John J et al. Abnormal signal-averaged electrocardiogram (SAECG) in obesity. Obes Res. 2000;8:20–8. doi:10.1038/oby.2000.4. [PubMed] [CrossRef] [Google Scholar]

98. Pardo F, Villalobos-Labra R, Chiarello DI et al. Molecular implications of adenosine in obesity. Mol Aspects Med. 2017;55:90–101. doi:10.1016/j.mam.2017.01.003. [PubMed] [CrossRef] [Google Scholar]

99. Kaartinen JM, Hreniuk SP, Martin LF et al. Attenuated adenosine-sensitivity and decreased adenosine-receptor number in adipocyte plasma membranes in human obesity. Biochem J. 1991;279:17–22. doi:10.1042/bj2790017. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

100. Thong FSL, Lally JSV, Dyck DJ et al. Activation of the A1 adenosine receptor increases insulin-stimulated glucose transport in isolated rat soleus muscle. Appl Physiol Nutr Metab. 2007;32:701–10. doi:10.1139/H07-039. [PubMed] [CrossRef] [Google Scholar]

101. Dhalla AK, Wong MY, Voshol PJ et al. A1 adenosine receptor partial agonist lowers plasma FFA and improves insulin resistance induced by high-fat diet in rodents. Am J Physiol Endocrinol Metab. 2007;292:E1358–63. doi:10.1152/ajpendo.00573.2006. [PubMed] [CrossRef] [Google Scholar]

102. Rice AM, Fain JN, Rivkees SA. A1 adenosine receptor activation increases adipocyte leptin secretion. Endocrinology. 2000;141:1442–5. doi:10.1210/endo.141.4.7423. [PubMed] [CrossRef] [Google Scholar]

103. Szkudelski T, Nogowski L, Szkudelska K. Short-term regulation of adiponectin secretion in rat adipocytes. Physiol Res. 2011;60:521–30. [PubMed] [Google Scholar]

104. Csóka B, Selmeczy Z, Koscsó B et al. Adenosine promotes alternative macrophage activation via A2A and A2B receptors. FASEB J. 2012;26:376–86. doi:10.1096/fj.11-190934. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

105. Ponikowski P, Anker SD, AlHabib KF et al. Heart failure: preventing disease and death worldwide. ESC Heart Fail. 2014;1:4–25. doi:10.1002/ehf2.12005. [PubMed] [CrossRef] [Google Scholar]

106. Writing Group Members. Mozaffarian D, Benjamin EJ et al. Heart disease and stroke statistics – 2016 update: a report from the American Heart Association. Circulation. 2016;133:e38–360. doi:10.1161/CIR.0000000000000350. [PubMed] [CrossRef] [Google Scholar]

107. Mamas MA, Sperrin M, Watson MC et al. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Fail. 2017;19:1095–104. doi:10.1002/ejhf.822. [PubMed] [CrossRef] [Google Scholar]

108. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) Lancet. 1999;353:2001–7. doi:10.1016/S0140-6736(99)04440-2. [PubMed] [CrossRef] [Google Scholar]

109. Marrouche NF, Brachmann J, Andresen D et al. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378:417–7. doi:10.1056/NEJMoa1707855. [PubMed] [CrossRef] [Google Scholar]

110. Allard MF, Schonekess BO, Henning SL et al. Contribution of oxidative metabolism and glycolysis to ATP production in hypertrophied hearts. Am J Physiol. 1994;267:H742–50. doi:10.1152/ajpheart.1994.267.2.H742. [PubMed] [CrossRef] [Google Scholar]

111. Bugger H, Schwarzer M, Chen D et al. Proteomic remodelling of mitochondrial oxidative pathways in pressure overload-induced heart failure. Cardiovasc Res. 2010;85:376–84. doi:10.1093/cvr/cvp344. [PubMed] [CrossRef] [Google Scholar]

112. Neubauer S. The failing heart – an engine out of fuel. N E. ngl J Med. 2007;356:1140–51. doi:10.1056/NEJMra063052. [PubMed] [CrossRef] [Google Scholar]

113. Bedi KC, Snyder NW, Brandimarto J et al. Evidence for intramyocardial disruption of lipid metabolism and increased myocardial ketone utilization in advanced human heart failure. Circulation. 2016;133:706–16. doi:10.1161/CIRCULATIONAHA.115.017545. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

114. Funakoshi H, Chan TO, Good JC et al. Regulated overexpression of the A1-adenosine receptor in mice results in adverse but reversible changes in cardiac morphology and function. Circulation. 2006;114:2240–50. doi:10.1161/CIRCULATIONAHA.106.620211. [PubMed] [CrossRef] [Google Scholar]

115. Funaya H, Kitakaze M, Node K et al. Plasma adenosine levels increase in patients with chronic heart failure. Circulation. 1997;95:1363–5. doi:10.1161/01.cir.95.6.1363. [PubMed] [CrossRef] [Google Scholar]

116. Chuo CH, Devine SM, Scammells PJ et al. VCP746, a novel A1 adenosine receptor biased agonist, reduces hypertrophy in a rat neonatal cardiac myocyte model. Clin Exp Pharmacol Physiol. 2016;43:976–82. doi:10.1111/1440-1681.12616. [PubMed] [CrossRef] [Google Scholar]

117. Finegan B A, Lopaschuk G D, Coulson C S et al. Adenosine alters glucose use during ischemia and reperfusion in isolated rat hearts. Circulation. 1993;87:900–8. doi:10.1161/01.CIR.87.3.900. [PubMed] [CrossRef] [Google Scholar]

118. Schütte F, Burgdorf C, Richardt G et al. Adenosine A1 receptor-mediated inhibition of myocardial norepinephrine release involves neither phospholipase C nor protein kinase C but does involve adenylyl cyclase. Can J Physiol Pharmacol. 2006;84:573–7. doi:10.1139/y06-007. [PubMed] [CrossRef] [Google Scholar]

119. Yuan K, Cao C, Han JH et al. Adenosine-stimulated atrial natriuretic peptide release through A1 receptor subtype. Hypertension. 2005;46:1381–7. doi:10.1161/01.HYP.0000190041.61737.fd. [PubMed] [CrossRef] [Google Scholar]

120. Vallon V, Miracle C, Thomson S. Adenosine and kidney function: potential implications in patients with heart failure. Eur J Heart Fail. 2008;10:176–87. doi:10.1016/j.ejheart.2008.01.010. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

121. Ferrucci L, Giallauria F, Guralnik JM. Epidemiology of aging. Radiol Clin North Am. 2008;46:643–52. doi:10.1016/j.rcl.2008.07.005. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

122. The Census Bureau on prospects for US population growth in the twenty-first century. Population and Development Review. 2000;26:197–200. doi:10.1111/j.1728-4457.2000.00197.x. [CrossRef] [Google Scholar]

123. Boriani G, Diemberger I, Martignani C et al. The epidemiological burden of atrial fibrillation: a challenge for clinicians and health care systems. Eur Heart J. 2006;27:893–4. doi:10.1093/eurheartj/ehi651. [PubMed] [CrossRef] [Google Scholar]

124. Boriani G. Atrial fibrillation and aging: risky mutual relationships. Chest. 2016;149:301–2. doi:10.1016/j.chest.2015.08.018. [PubMed] [CrossRef] [Google Scholar]

125. Thacker EL, McKnight B, Psaty BM et al. Atrial fibrillation and cognitive decline: a longitudinal cohort study. Neurology. 2013;81:119–25. doi:10.1212/WNL.0b013e31829a33d1. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

126. Chugh SS, Jui J, Gunson K et al. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large US community. J Am Coll Cardiol. 2004;44:1268–75. doi:10.1016/j.jacc.2004.06.029. [PubMed] [CrossRef] [Google Scholar]

127. Santangeli P, Di Biase L, Dello Russo A et al. Meta-analysis: age and effectiveness of prophylactic implantable cardioverter-defibrillators. Ann Intern Med. 2010;153:592–9. doi:10.7326/0003-4819-153-9-201011020-00009. [PubMed] [CrossRef] [Google Scholar]

128. Mariani J, Ou R, Bailey M et al. Tolerance to ischemia and hypoxia is reduced in aged human myocardium. J Thorac Cardiovasc Surg. 2000;120:660–7. doi:10.1067/mtc.2000.106528. [PubMed] [CrossRef] [Google Scholar]

129. Lorbar M, Fenton RA, Duffy AJ et al. Effect of aging on myocardial adenosine production, adenosine uptake and adenosine kinase activity in rats. J Mol Cell Cardiol. 1999;31:401–12. doi:10.1006/jmcc.1998.0877. [PubMed] [CrossRef] [Google Scholar]

130. Gao E, Snyder DL, Johnson MD et al. The effect of age on adenosine A1 receptor function in the rat heart. J Mol Cell Cardiol. 1997;29:593–602. doi:10.1006/jmcc.1996.0302. [PubMed] [CrossRef] [Google Scholar]

131. Xu J, Gao F, Ma XL et al. Effect of aging on the negative chronotropic and anti-beta-adrenergic actions of adenosine in the rat heart. J Cardiovasc Pharmacol. 1999;34:904–12. doi:10.1097/00005344-199912000-00020. [PubMed] [CrossRef] [Google Scholar]

132. Camaiti A, Del Rosso A, Morettini A et al. Efficacy and safety of adenosine in diagnosis and treatment of regular tachycardia in the elderly. Coron Artery Dis. 1998;9:591–6. doi:10.1097/00019501-199809090-00006. [PubMed] [CrossRef] [Google Scholar]

133. Cushley MJ, Tattersfield AE, Holgate ST. Inhaled adenosine and guanosine on airway resistance in normal and asthmatic subjects. Br J Clin Pharmacol. 1983;15:161–5. doi:10.1111/j.1365-2125.1983.tb01481.x. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

134. Cerqueira MD, Verani MS, Schwaiger M et al. Safety profile of adenosine stress perfusion imaging: results from the Adenoscan Multicenter Trial Registry. J Am Coll Cardiol. 1994;23:384–9. doi:10.1016/0735-1097(94)90424-3. [PubMed] [CrossRef] [Google Scholar]

135. Burki NK, Dale WJ, Lee L-Y. Intravenous adenosine and dyspnea in humans. J Appl Physiol (1985) 2005;98:180–5. doi:10.1152/japplphysiol.00913.2004. [PubMed] [CrossRef] [Google Scholar]

136. Burki NK, Alam M, Lee L-Y. The pulmonary effects of intravenous adenosine in asthmatic subjects. Respir Res. 2006;7:139. doi:10.1186/1465-9921-7-139. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

137. Kwong K, Hong JL, Morton RF et al. Role of pulmonary C fibers in adenosine-induced respiratory inhibition in anesthetized rats. J Appl Physiol (1985) 1998;84:417–24. doi:10.1152/jappl.1998.84.2.417. [PubMed] [CrossRef] [Google Scholar]

138. Hong JL, Ho CY, Kwong K et al. Activation of pulmonary C fibres by adenosine in anaesthetized rats: role of adenosine A1 receptors. J Physiol. 1998;508:109–18. doi:10.1111/j.1469-7793.1998.109br.x. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

139. DeGroff CG, Silka MJ. Bronchospasm after intravenous administration of adenosine in a patient with asthma. J P. ediatr. 1994;125:822–23. doi:10.1016/s0022-3476(94)70085-0. [PubMed] [CrossRef] [Google Scholar]

140. Burkhart KK. Respiratory failure following adenosine administration. Am J Emerg Med. 1993;11:249–50. doi:10.1016/0735-6757(93)90138-2. [PubMed] [CrossRef] [Google Scholar]

141. Coli S, Mantovani F, Ferro J et al. Adenosine-induced severe bronchospasm in a patient without pulmonary disease. Am J Emerg Med. 2012;30:2082.e3–5. doi:10.1016/j.ajem.2011.11.005. [PubMed] [CrossRef] [Google Scholar]

142. Zhou Y, Murthy JN, Zeng D et al. Alterations in adenosine metabolism and signaling in patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. PloS One. 2010;5:e9224. doi:10.1371/journal.pone.0009224. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

143. Picher M, Burch LH, Boucher RC. Metabolism of P2 receptor agonists in human airways: implications for mucociliary clearance and cystic fibrosis. J Biol Chem. 2004;279:20234–41. doi:10.1074/jbc.M400305200. [PubMed] [CrossRef] [Google Scholar]

144. Pelleg A, Pennock RS, Kutalek SP. Proarrhythmic effects of adenosine: one decade of clinical data. Am J Ther. 2002;9:141–7. doi:10.1097/00045391-200203000-00008. [PubMed] [CrossRef] [Google Scholar]

145. Reed R, Falk JL, O’Brien J. Untoward reaction to adenosine therapy for supraventricular tachycardia. Am J Emerg Med. 1991;9:566–70. doi:10.1016/0735-6757(91)90117-3. [PubMed] [CrossRef] [Google Scholar]

146. Tomcsányi J, Tenczer J, Horváth L. Unusual effect of adenosine. Int J Cardiol. 1995;49:89–91. doi:10.1016/0167-5273(95)02274-Z. [PubMed] [CrossRef] [Google Scholar]

147. Brodsky MA, Hwang C, Hunter D et al. Life-threatening alterations in heart rate after the use of adenosine in atrial flutter. Am Heart J. 1995;130:564–71. doi:10.1016/0002-8703(95)90367-4. [PubMed] [CrossRef] [Google Scholar]

148. McCollam PL, Uber WE, Van Bakel AB. Adenosine-related ventricular asystole. Ann Intern Med. 1993;118:315–6. doi:10.7326/0003-4819-118-4-199302150-00023. [PubMed] [CrossRef] [Google Scholar]

149. Giedd KN, Bokhari S, Daniele TP et al. Sinus arrest during adenosine stress testing in liver transplant recipients with graft failure: three case reports and a review of the literature. J Nucl Cardiol. 2005;12:696–702. doi:10.1016/j.nuclcard.2005.07.007. [PubMed] [CrossRef] [Google Scholar]

150. Dierkes S, Hennersdorf MG, Perings C et al. Enlarged effects of adenosine in a septic patient with multiple myeloma and atrial flutter. Acta Cardiol. 2003;58:363–6. doi:10.2143/AC.58.4.2005296. [PubMed] [CrossRef] [Google Scholar]

151. Belloni FL, Wang J, Hintze TH. Adenosine causes bradycardia in pacing-induced cardiac failure. Circulation. 1992;85:1118–24. doi:10.1161/01.cir.85.3.1118. [PubMed] [CrossRef] [Google Scholar]

152. Webster DP, Daar AA. Prolonged bradyasystole and seizures following intravenous adenosine for supraventricular tachycardia. Am J Emerg Med. 1993;11:192–4. doi:10.1016/0735-6757(93)90121-Q. [PubMed] [CrossRef] [Google Scholar]

153. Harrington GR, Froelich EG. Adenosine-induced torsades de pointes. Chest. 1993;103:1299–301. doi:10.1378/chest.103.4.1299. [PubMed] [CrossRef] [Google Scholar]

154. Wesley RC, Turnquest P. Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome. Am Heart J. 1992;123:794–6. doi:10.1016/0002-8703(92)90525-z. [PubMed] [CrossRef] [Google Scholar]

155. Teodorovich N, Margolin E, Kogan Y et al. Torsades de pointes after adenosine administration. J Electrocardiol. 2016;49:171–3. doi:10.1016/j.jelectrocard.2015.12.013. [PubMed] [CrossRef] [Google Scholar]

156. Frank R, Marty H. Polymorphic ventricular tachycardia after intravenous adenosine. Schweiz Med Wochenschr. 2000;130:1576. [in German] [PubMed] [Google Scholar]

157. Kaplan IV, Kaplan AV, Fisher JD. Adenosine induced atrial fibrillation precipitating polymorphic ventricular tachycardia. Pacing Clin Electrophysiol. 2000;23:140–1. doi:10.1111/j.1540-8159.2000.tb00662.x. [PubMed] [CrossRef] [Google Scholar]

158. Huemer M, Boldt L-H, Rolf S et al. Sustained monomorphic ventricular tachycardia after adenosine infusion. Int J Cardiol. 2009;131:e97–100. doi:10.1016/j.ijcard.2007.07.068. [PubMed] [CrossRef] [Google Scholar]

159. Pella J, Stancák B, Komanová E et al. Ventricular fibrillation after administration of adenosine. Vnitr Lek. 1995;41:832–5. [in Slovak] [PubMed] [Google Scholar]

160. Parham WA, Mehdirad AA, Biermann KM et al. Case report: adenosine induced ventricular fibrillation in a patient with stable ventricular tachycardia. J Interv Card Electrophysiol. 2001;5:71–4. doi:10.1023/A:1009810025584. [PubMed] [CrossRef] [Google Scholar]

161. Gupta AK, Shah CP, Maheshwari A et al. Adenosine induced ventricular fibrillation in Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2002;25:477–80. doi:10.1046/j.1460-9592.2002.00477.x. [PubMed] [CrossRef] [Google Scholar]

162. Celiker A, Tokel K, Cil E et al. Adenosine induced torsades de pointes in a child with congenital long QT syndrome. Pacing Clin Electrophysiol. 1994;17:1814–7. doi:10.1111/j.1540-8159.1994.tb03752.x. [PubMed] [CrossRef] [Google Scholar]

163. Piccolo R, Niglio T, Di Gioia G et al. Adenosine-induced torsade de pointes complicating a fractional flow reserve measurement in a right coronary artery intermediate stenosis. Cardiovasc Revasc Med. 2013;14:118–20. doi:10.1016/j.carrev.2012.12.010. [PubMed] [CrossRef] [Google Scholar]

164. Shah AH, Chan W, Seidelin PH. Ventricular fibrillation precipitated by intracoronary adenosine during fractional flow reserve assessment – a cautionary tale. Heart Lung Circ. 2015;24:e173–5. doi:10.1016/j.hlc.2015.05.012. [PubMed] [CrossRef] [Google Scholar]

165. Khan ZA, Akbar G, Saeed W et al. Ventricular fibrillation with intracoronary adenosine during fractional flow reserve assessment. Cardiovasc Revasc Med. 2016;17:487–9. doi:10.1016/j.carrev.2016.07.004. [PubMed] [CrossRef] [Google Scholar]

166. Patel HR, Shah P, Bajaj S et al. Intracoronary adenosine-induced ventricular arrhythmias during fractional flow reserve (FFR) measurement: case series and literature review. Cardiovasc Interv Ther. 2017;32:374–80. doi:10.1007/s12928-016-0427-8. [PubMed] [CrossRef] [Google Scholar]

167. Flyer JN, Zuckerman WA, Richmond ME et al. Prospective study of adenosine on atrioventricular nodal conduction in pediatric and young adult patients after heart transplantation. Circulation. 2017;135:2485–93. doi:10.1161/CIRCULATIONAHA.117.028087. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

168. Conti JB, Belardinelli L, Utterback DB et al. Endogenous adenosine is an antiarrhythmic agent. Circulation. 1995;91:1761–7. doi:10.1161/01.cir.91.6.1761. [PubMed] [CrossRef] [Google Scholar]

169. Camm AJ, Garratt CJ. Adenosine and supraventricular tachycardia. N Engl J Med. 1991;325:1621–9. doi:10.1056/NEJM199112053252306. [PubMed] [CrossRef] [Google Scholar]

170. Watt AH, Bernard MS, Webster J et al. Intravenous adenosine in the treatment of supraventricular tachycardia: a dose-ranging study and interaction with dipyridamole. Br J Clin Pharmacol. 1986;21:227–30. doi:10.1111/j.1365-2125.1986.tb05180.x. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

171. Znojkiewicz P, Spector PS. Parsons PE, Wiener-Kronish JP. Critical Care Secrets. 5th ed. Philadelphia, PA: Mosby; 2013. pp. 197–203. Dysrhythmias and tachyarrhythmias. In: [CrossRef] [Google Scholar]

172. Kanei Y, Hanon S, Van-Tosh A et al. Adenosine-induced atrial fibrillation during pharmacologic stress testing: Report of eight cases and review of the literature. Int J Cardiol. 2008;129:e15–7. doi:10.1016/j.ijcard.2007.05.090. [PubMed] [CrossRef] [Google Scholar]

173. Knight BP, Zivin A, Souza J et al. Use of adenosine in patients hospitalized in a university medical center. Am J Med. 1998;105:275–80. doi:10.1016/S0002-9343(98)00261-7. [PubMed] [CrossRef] [Google Scholar]

Unmasking Adenosine: The Purinergic Signalling Molecule Critical to Arrhythmia Pathophysiology and Management (2024)
Top Articles
Latest Posts
Article information

Author: Rev. Leonie Wyman

Last Updated:

Views: 5908

Rating: 4.9 / 5 (59 voted)

Reviews: 90% of readers found this page helpful

Author information

Name: Rev. Leonie Wyman

Birthday: 1993-07-01

Address: Suite 763 6272 Lang Bypass, New Xochitlport, VT 72704-3308

Phone: +22014484519944

Job: Banking Officer

Hobby: Sailing, Gaming, Basketball, Calligraphy, Mycology, Astronomy, Juggling

Introduction: My name is Rev. Leonie Wyman, I am a colorful, tasty, splendid, fair, witty, gorgeous, splendid person who loves writing and wants to share my knowledge and understanding with you.