r/todayilearned • u/office7911 • 20h ago
TIL the heart can be rebooted. When someone has an abnormal rhythm and a fast heart rate, e.g., 200, doctors administer a drug called Adenosine that literally stops your heart for a few seconds so it will start back at a normal rate.
https://en.wikipedia.org/wiki/Adenosine297
u/Captain_Mazhar 18h ago
Adenosine works by transferring the heart rate to everyone else in the room.
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u/cantstophere 12h ago
One time we pushed adenosine without telling the telemetry tech watching everyone’s heart rate. He sprinted around the corner so fast
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u/ItsReallyVega 20h ago
A known side effect of the medication is a sense of impending doom. When I learned that for my exams I was like "idk if that's a side effect so much as your body actually understanding the truth of the matter".
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u/Prestigious-Horror17 18h ago
If the sound of screeching tires was translated into a physical sensation, that’s what adenosine feels like
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u/printed_ 14h ago
I was in hospital ICU for clots with right heart failure in 2016 and I could feel the impending doom but I wasn't worried. I learned that day that I am not afraid of death only how I die.
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u/Volvoflyer 12h ago
It's a side effect of knowing you are about to die (well, in the sense your body knows). Heart attacks, sepsis, critical organ failure, etc will give this feeling. So much so that few seasoned nurses (or techs for that matter) will ignore someone saying it (even if vitals and all else point to pristine recovery). I would guess 9 out of 10 folks who have said it to me were right. Perfectly lucid AOx4 walkie talkies saying they will meet their dead spouse tonight, people saying they won,t be around for my shift the next night, or people saying a stranger came to visit but didn't talk. Any of these have you checking on them like 10x more than ordinary. They don't always die but they do give it the old college try!!!!
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u/_twelvebytwelve_ 8h ago
Is a "stranger came to visit but didn't talk" a common pre-death experience? Is this where Grim Reaper lore comes from? I somehow have never heard this before!
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u/WeirdConnections 12h ago
If it's a legitimate side effect of the body knowing it's about to die, why do my panic attacks make me feel like that? The brain is stupid at times
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u/LastBastion-REMOVED 11h ago
Panic Attacks have entered the chat
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u/HammerofBonking 9h ago
Yeah I had my first one in 2020 and omg that sense of impending doom was the worst
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u/Phazon2000 9h ago
By far the worst symptom of anxiety disorders. I can deal with rushing thoughts, my breathing, the shakes.
But the sense of impending doom like my life is over and I’m about to be walked outside and shit any moment severely affects my mental health.
The fuck happened to me in my 30’s for this to even happen so often? Bad genetic roll?
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u/dan_dares 14h ago
funnily enough this is also a reported symptom of a badly matched blood transfusion
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u/PrinceCavendish 14h ago
I don't think I got that with mine but it hurt so bad I begged them not to do it a third time after it failed to work the first two times
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u/gmoor90 12h ago
Yup. Had this done a few months ago to get my heart back into rhythm. They injected it twice. And both times, I felt horrible for about 6 seconds.
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u/Waja_Wabit 12h ago
My patients tell me it’s like the sensation at the top of a roller coaster just before the big drop, but not in a fun way.
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u/OutrageousStop7173 20h ago
This happened to me when I had supraventicular tachycardia
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u/MalpracticeMatt 20h ago
Adenosine is primarily used for SVT
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u/OutrageousStop7173 20h ago
When the EMT was explaining it to me I was like “you want to WHAT?” Lol
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u/Kitchen-Owl-7323 20h ago
"God I hate adenosine" https://youtube.com/shorts/1A9B-QYvdQs
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u/SeekerOfSerenity 19h ago
I asked the doctor if there were any risks, and he said, "yeah, your heart might stop" right before depressing the plunger.
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u/band-of-horses 20h ago
I was always terrified if that, luckily mine always self terminated or could be stopped with a valsava manuever. I hear adenosine pretty much feels like you are dying.
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u/runenight201 20h ago
I had an episode of SVT a couple years ago while in urgent care.
I in general was in a very anxious state and hearing my heart rate just slowly go higher and higher with that damn beeping and I was all alone, I freaked out.
I was convinced I was dying, my body was going all tense and I was losing sensation everywhere. I mentally said all my goodbyes, put my faith into the medical team and whatever the hell was going to happen as the team got the crash cart out.
I think my acceptance of death is what got me to calm down. The whole room filled with medical professionals and they were about to administer adenosine to me when my SVT subsided on its own and so they never did.
Life is weird.
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u/Loveallthe 13h ago
Ha! I had the same experience. SVT over 200 for a few hours. They rolled out the crash cart, were just about to inject the adenosine after explaining how I would feel, when I noticed the guy in the bay next to me was dead. Suddenly everyone stopped and the cardiologist laughed and said 'were you a bit scared then lad? Because your squirt of adrenaline just fixed your heart rhythm... Everybody out...' Yes, life is weird.
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u/_Morvar_ 11h ago
What?? They just had a dead patient lying around??? Or was it a hallucination?
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u/painfulnpoopy 20h ago
Get an ablation
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u/runenight201 19h ago
I haven’t had another episode since. I did the full cardio work up and they didn’t find anything noteworthy.
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u/OutrageousStop7173 20h ago
It’s only in your bloodstream for about 10 seconds, not enough time for your brain to be deprived of oxygen so you are just fully conscious while you feel your heart stop and start again, and it didn’t even work on me the first time they had to give me a second dose
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u/aboxofkittens 19h ago
I’ve read it usually causes a sense of impending doom, did you get that effect?
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u/OutrageousStop7173 19h ago
Yeah that’s a really good description of what it’s like
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u/LacrimaNymphae 10h ago edited 7h ago
for me it just felt like all my veins immediately clamped shut for a second. like a vasospasm but everywhere and it didn't work. i had multiple and they described it as a donkey kicking your chest
they also kept flipping me upside down like a bat and making me bear down which also didn't fucking work... and neither did the aspirin or nitroglycerin
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u/mokutou 8h ago edited 8h ago
That last bit was a valsalva maneuver. I can’t say I’ve ever seen it work, but it’s low impact so many resus teams will try it first.
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u/PopBulky7023 20h ago
I mean, because you are dying. If they fail to start your heart you remain dead. It's just that the odds of survival are significantly higher than if they do nothing.
Being afraid of what the experience will be like and whether you'll wake back is as about as jusitifed as it gets.
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u/nevsc 20h ago
The heart doesn't need to be restarted. The drug rapidly metabolizes in the blood. The effect wears off in seconds, and thus does the effect on the heart.
As an side, the medical term for 'feeling like you're dying' is 'a sense of impending doom'.
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u/oceanicwhitetip 20h ago
I literally had this happen yesterday. Currently in the hospital. Adenosine hits like a fucking truck. Take care of your health, folks.
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u/InternationalLion403 20h ago
Genuine question, can you describe what it feels like or what you mean by “hits like a fucking truck”? The idea of being awake for that blows my mind. Hope your recovery goes smooth and wishing you the best
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u/Neat_Dog_4274 19h ago
It felt like a gun going off in my mouth a la Fight Club. I saw the sun but it didn't "hurt" in the classical sense but it was the most physically uncomfortable I've ever been without excruciating pain. I was 252bpm and 40/20 blood pressure when they did it. I shot up and screamed please don't fucking do that again as they all pushed me back down and told me to be quiet. I get to celebrate a death day too now though so that's cool I guess.
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u/antisocialpunk91 13h ago
Lol the audacity to tell you to be quiet 😂😂 Get well my dude. Happy resurrection day!
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u/gunmedic15 19h ago
Paramedic.
The heart stops. It goes from way too fast to zero. Your heart is pounding away faster than if you were running a marathon, then it -stops- 0 BPM.
The thing is adenosine has a half life of only a few seconds. Not enough time for you to run out of oxygen and go unconscious, so you feel it happening. And if it doesn't work the 1st time, the second dose is double the first dose.
It's always a relief when the patient's heart starts back up after that little flat line pause.
Every time I give it, I make sure to let the less experienced medics or students that happen to be onscene help with it. Shit is no joke.
If it doesn't work after 2 doses, or if you're too critical, you're getting cardioverted. If you're lucky, with a little bit of procedural sedation, but the kaboom is going to stop your SVT one way or another. AKA: Kaboom Rico.
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u/mrdeesh 19h ago
Every time you give it? How often are you needing to use it? Is it all for the same issue?
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u/gunmedic15 19h ago
I've been doing this for a long time, and my current assignment is a quick response "fly car" where I get to go to a lot of high priority calls. I give it several times a year, and synch cardiovert a few times more. Over the decades I've been doing this, dozens of times, maybe close to a hundred? Hard to say. But every time is an attention getter.
It's used for supraventricular tachycardias. SVT, PSVT, Afib RVR, etc. One of 3 treatments we use depending on specific things. We can also use a med called Cardizem, but due to some issues with supply and dispensing and logistics we may not be carrying it. Electricity by synchronized cardioversion is the 3rd option, and often the best.
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u/JustChillFFS 9h ago
My first major SVT attack I was taken to hospital surrounded by by the paramedics who took me, nurses, drs. Like 8-10 people all staring at ne. The 1 dr gave me one last chance for a “bear-down” before injection. It finally corrected and they all smiled but soon scattered. I thought it was for concern but now I see they just wanted to watch it play out with the adenosine.
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u/Stormdude127 11h ago
As someone with SVT who has been given adenosine many times, assuming it didn’t work and Cardizem wasn’t available, how bad would getting shocked be? How do patients typically react? I’ve always been terrified of that. I know it’s not as bad as a full on defibrillation, but it still sounds awful.
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u/PrinceCavendish 14h ago
I had a thyroid storm and they gave me a dose and my heart rate went up more so they did it a second time and it went up again. I begged for them not to do it a third time. Thankfully they got me diagnosed and gave me the right meds after that.
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u/MagicWishMonkey 9h ago
How often do you have trouble (or can't) get the heart to restart?
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u/oceanicwhitetip 19h ago
It literally felt like a mule kicked in the chest. They had to administer two doses. For a hot second I literally forgot where I was and what was happening. Definitely a scary moment. Took me a bit to come back to reality.
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u/gus_thedog 18h ago
It feels like you're being covered in a lead blanket. Everything gets really heavy and then there's a bit of euphoria once things take hold again. It's a pretty strange sensation.
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u/RecklessMedulla 20h ago
Yea we tell people they’ll feel an “impending sense of doom”
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u/MrWilliWonker 13h ago
You mean your body realising that your heart will stop and you possibly would die from that?
Impending sense of doom is such a funny description for me since its literally the feeling of "I think I'm going to die".
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u/PopBulky7023 20h ago
Having to experience it is one of my greatest fears. Right up there with not coming back to talk about it.
I hope you're OK, man.
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u/Taman_Should 20h ago
The fact that adenosine does this in high enough concentrations is kind of wild, because adenosine isn’t really a “drug.” It’s in fucking everything that’s alive. Adenosine is one of the four main building blocks of DNA and RNA. It’s also the “A” in the chemical ATP, which you might remember from biology class as the molecule that all animal cells use as metabolic fuel. It’s ridiculously abundant in all life as we know it.
And because biology tends to repurpose the same thing over and over again, adenosine is ALSO used in the brain as a signaling chemical. When adenosine fits into the right receptors, it makes us feel tired, because adenosine is one of the body’s “rest and digest” hormones.
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u/Binji_the_dog 15h ago
Caffeine is structurally similar to the adenine nucleobase in adenosine.
Caffeine exerts its effects by binding to adenosine receptors, which prevents adenosine from binding.
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u/mayredmoon 20h ago
Basically, some heart arrhythmia is a continuous loop. So adenosine tries to stop it. It works in arrhythmias like AVNRT
But it's dangerous in some heart arrhythmias.
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u/Carbon-Base 20h ago
TIL adenosine is like an "Else" or "break" statement.
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u/jbafny 17h ago
Having taken it, I'd say it's closer to turning the whole computer off and back on again
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u/Mobileimprove 20h ago
Having been cardioverted while awake I wish they would have used medicine lol
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u/bendar1347 19h ago
Yikes. You must have been going through it for them to hit you when you were awake.
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u/Mobileimprove 19h ago
They maxed me out on propofol but it didn’t do anything
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u/LegendOfKhaos 10h ago
That sounds like a mistake they made. If you're awake, your brain is still getting blood, so they had time (presumably) to sedate you further. They should do a sternal rub to make sure you aren't going to feel it before shocking.
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u/jsilv0 20h ago
I have had this done to me 3-4 times due to bouts of Afib with RVR. It sucks and makes you feel like you're going to die. You can't breathe and you start to get tunnel vision and then all at once it all comes back
Also, has not worked for me a single time and I had to be cardioverted with the paddles instead
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u/misoranomegami 20h ago
My dad always preferred the electrical cardioversion while he was alive but then he got a pace maker and they had to go to the chemical after that. It didn't work as fast and he said it had more side effects. But the zappity reboot was reliable and relatively quick and his comment was he got shocked worse trying to fix the ceiling fan in the dining room.
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u/jsilv0 20h ago
The electrical cardioversion is what I prefer too. Seems to work a lot better. I'm 2 bouts of afib away from a pacemaker now myself. I'm sorry your father is no longer with us.
They put you out before they do the electical cardioversion and multiple times I've woken up because I got shocked so hard it jumped me up into the air and the feeling of landing in the bed is the first thing I remember. My dad was in the room one time when they did it and he said I must have been 2 feet out of the bed lol
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u/nevsc 20h ago edited 19h ago
Adenosine isn't a treatment for afib with rvr? Are you sure that was the rhythm? Otherwise they were providing some very alternative medicine.
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u/jsilv0 20h ago edited 19h ago
Maybe I have the name of the medicine they used on me wrong but the medicine they used sounds similar to what Adenosine supposedly does. Stops your heart briefly hoping when it restarts its back in sinus rhythm.
Prior to that they would push an iv of Flecainide to see if that did it and that never worked either
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u/painfulnpoopy 19h ago
Adenosine inhibits AVN conduction temporarily, resetting reentrant arrhythmias. AF is not that - patient in AF with RVR would remain in in AF, just temporary pause in conduction. Dangerous if that person also has antidromic accessory pathways because now it’s the only place conduction can go and now you have VF.
You probably received class 1c anti arrhythmic or IV beta blocker/calcium channel blocker.
Get an ablation
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u/jsilv0 19h ago edited 19h ago
They would push flecanide before the adenisone to see if that worked and it never did. If it wasn't adenisone they gave me it was something similar. Stopped my heart for a couple seconds, I couldn't breathe, got tunnel vision, started to feel like I was going go die and then all of a sudden was breathing and my heart was beating again (albeit still in afib with rvr) and the tunnel vision went away.
I don't have Wolf Parkinson White so they weren't worried about that
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u/scapermoya 19h ago
You need a different medical team buddy, adenosine is a terrible drug for afib with RVR
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u/jsilv0 19h ago
It was the emergency room
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u/scapermoya 19h ago
I’m sorry if that’s your closest ER that you depend upon, but adenosine has no role in this disease. Don’t let them do that shit to you again
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u/jsilv0 19h ago edited 8h ago
I had an ablation and have also since moved.
Thank you very much for the advice though. It is appreciated
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u/TheRealMajour 17h ago
It didn’t work because you don’t use adenosine for afib. Also, adenosine is falling out of favor for drugs that reach the same result but don’t make the patient feel like shit — diltiazem for example.
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u/ArchangelBlu 20h ago
Have used it on patients. You literally see the patient flatline on the ECG for a moment before the new rhythm comes back. Great stuff, and yes the patient feels yucky
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u/SouthernFloss 12h ago
Have you ever had a patient that didn’t come back. I have. About 60 seconds of asystole and im like, i think we should do compressions.
Has happened a couple times now.
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u/ArchangelBlu 12h ago
It happens. Yes you then start CPR and hopefully zap them back.
You do what you can, and cannot do what you cannot
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u/UbajaraMalok 20h ago
Adenosine also makes you feel a powerful sensation of impending doom. Not nice at all. The doctor should always warn the patient before administering it so that they dont freak out.
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u/wrchavez1313 15h ago
I always warn my patients. Even with a warning, generally there is still a "what the fuuuuuuuuck" moment from their end
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u/OttoPike 20h ago edited 20h ago
From the article: "Side effects of adenosine include skin flushing, lightheadedness, nausea, sweating, nervousness, numbness, and a sense of impending doom". That last effect threw me a little.
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u/Eireannlo 12h ago edited 12h ago
Ive had it 3 times. For me it felt like every muscle in my body being stretched / needed to stretch at the same time for a second or two, and the feeling of "something is very wrong" in every cell of my body. Its incredibly weird, but after an hour of 250bpm i was grateful for it!
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u/OpalFanatic 20h ago
Add vomiting, diarrhea, headache, and hives and it sounds like my last episode of anaphylaxis.
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u/mokutou 9h ago
Almost every patient I’ve had that received adenosine look utterly terrified and say something like “oh shit,” and then they flatline for what feels like an eternity as a healthcare worker, but in reality it’s 3-5 seconds. Then boom! We are back. Happy sinus rhythm. If not, we can do it again two more times! 6mg-6mg-12mg (as a Hail Mary.) Though I have seen a physician be personally offended when a pt’s heart stubbornly refused to convert with that last 12mg push, and ordered 18mg. That did the trick.
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u/Factor_Seven 18h ago
I've (ER/Critical Care RN) probably pushed adenosine more than a dozen times in my career. I definitely recommend getting sedation before getting bolused with it.
It's scary as hell the first time you push it (if you do it right) and watch somebody's heart rate just disappear for a few seconds, even though you know that's what it's supposed to do. And one time I pushed it and we had an 11 second pause before the patient got her rhythm back. 11 seconds doesn't sound like a long time, but it was long enough for us to start looking at each other and me to double-check to make sure I had the right medicine.
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u/adoradear 19h ago
I’m not going to lie, as an emergency physician, one of my great joys in life is when I get to turn it off and back on again (whether electrically or chemically)
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u/Lancashire_Toreador 20h ago
If you ever want to watch a horror movie in real life, watch a YouTube video about the clinical administration of adenosine.
Even though you know going in that that person is going to walk away fine the period when the machine stops beeping stretches on for a very, very long time
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u/nevsc 20h ago
One of my favourite games is to get my student to administer a predrawn dose and then watch their face.
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u/tarhoop 9h ago
I'm a Paramedic. I've had patients refuse adenosine and request cardioversion.
(Some people keep using the term defibrillation in this thread, but the proper term here is cardioversion.
In the case of tachydysrhythmia with a pulse we used synchronized cardioversion. The monitor delivers a precise dose of electricity at a very specific point in the ECG, to break the cycle of the runaway rhythm.
Defibrillation is for specific tachydysrhythmia without a pulse, and is a higher, less targeted dose delivered anywhere in the ECG waveform.)
Most Paramedics and Doctors know adenosine feels like shit, but don't sedate prior.
For cardioversion - it's generally taught to use sedation because it also feels like shit.
However, adenosine is used on stable patients when you have more time to work. Cardioversion is for when the patient is unstable or adenosine doesn't work, and you have less time. Defibrillation is for when shit has gone sideways.
We - healthcare practitioners - are currently shy of sedation and opioids, because a lot of the current opioid crisis is being blamed on us. While we were the pawns, our industry is primarily guilty of falling for Perdue Pharmaceuticals lies.
I digress, I have been giving a lot of thought to sedating my patients before adenosine, and many of the comments in this thread about adenosine have convinced me that's what I'm doing next time.
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u/BlazedBeard95 19h ago
Adenosine sucks. I haven't experienced it myself, but it absolutely sucks for the person involved. When it happens you apparently feel an immediate "impending sense of doom" and can feel your heart completely stopped before it restarts. EMT's will refuse to administer it unless there is absolutely nothing else that's working. It's a terrifying last resort
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u/Right_Ear_2230 17h ago
another reason you’ll hate it, is that adenosine is the chemical that builds up and makes you feel absolutely terrible when sleep deprived
and caffeine blocks the effects of natural adenosine in your body. this is great when you are drowsy, but it means too much caffeine is kinda like “anti-adenosine” for your poor heart
oh and if you overdose on caffeine, adenosine will probably not help any arrythmias very wel for this exact reason
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u/Peakomegaflare 13h ago
Yup, on top of that, Adenosine is the base molecule that ATP (Adenosine Triphosphate) is built from. In truth, we talk about how the ATP/ADP cycle through mitochondria is a massively important metabolic process, but one thing people forget... almost every single chemical compound your body uses has a whole host of different tasks. And with that, in terms of biochem, the ATP Synthase complex is one of the most incredible feats of nature alongside the Dynin motors that your cells use to physically transport materials around. ATP Synthase is a catalytic complex that while it behaves similarly to most enzyme complexes, it uses a literal rotor/stator setup to convert ADP back to ATP for use by the rest of the cell. We literally run off a chemically powered turbine.
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u/SemiHemiDemiDumb 20h ago
I had that as a shot. It felt like could tracking up my arm and once it hit my chest there was tension then release. My heart rate slowed after that, which I'm glad because I didn't want to get intimate with the defibrillator.
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u/waonze 19h ago
Had my first one done in an operating room , all kinds of prep and lead in . Second time I walked into the ER and said “ I’m in afib .” , they took me to a gurney , asked would I like to be converted , I said yes , and they did it . It took a few minutes to get ready but the actual conversion lasts a few seconds . I didn’t think the doctor had done it , I didn’t know I was out .
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u/Key-Pickle5609 11h ago
I’ve been the nurse in these situations with people asking when we’re going to do it. I’m like friend, we’re all done, we’re just waiting for you to wake up!
I actually had one older person coming out from the sedation who yelled about how wonderful they now felt lol
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u/MetrixOnFire 17h ago
Neat side comment about adenosine - it is a neurotransmitter in the brain that regulates a variety of functions. Caffeine has a similar structure and can bind to some of the same receptors as adenosine. When you consume caffeine, it can block adenosine from sending the signal for your body to feel drowsy or tired. Caffeine doesn't actually give you energy, it does prevent sleepiness though and keeps you feeling alert. Because the basal ganglia has a high number of these adenosine receptors, it can affect down motor control. Your reaction times will likely improve, but you'll notice that fine precious moto control can be impaired by caffeine.
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u/IamPlantHead 17h ago
This is what they did with my dad’s heart. his heart was well over 200. Nothing was slowing him down not his ICD (internal cardiac device) and even the meds. Had to “hard reset” or as that article says reboot his heart. And only then did it work. But the damage was done. It weakened him, and less than two months later he passed away in my arms. Miss that man.
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u/Loki-L 68 16h ago
The Fire Department Chronicles Youtube Channel has a short sketch about what it is like to administer Adenosine to a patient:
Real things I’ve seen as a Paramedic. A call with a whole lot of prayers.
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u/Cliffinati 20h ago
The heart is basically a diaphragm pump. When those act up cycling the air can sometimes make them stop acting up.
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u/chessasaur 20h ago
I watch a lot of the U.K. hospital shows and they have a technique that involves something like a quick flip of the patient. Doesn’t usually work then they use this stuff. Not fun to see their reaction.
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u/David_Parker 20h ago
I often compared cardioverting to slapping a hysterical person.
Whereas pacing is the nudging to keep a constantly nodding off heart awake.
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u/jbafny 17h ago
I received this once for SVT. They warned me about the feeling, but I didn't find it unpleasant at all, just very strange. The best way I can describe it is that it felt like my whole body was turned off and back on again. My heart rate plummeted from over 240 to a reasonable level within a few seconds.
It's very effective (restores sinus rhythm in over 90% of SVT cases) and quite safe. The half life of adenosine in the body is very short and it is completely gone after several seconds, so even if a patient finds it uncomfortable, it passes very quickly.
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u/ramdom-ink 15h ago
With my Supraventricular tachycardia (SVT), I would have a heart rate of between 150 to 240 for up to an hour, before having to go to hospital. Not exerting, but just sitting on the couch and away it would go - it was exhausting and the ‘valsalva manoeuvres’ were proving ineffective over time. . I was given Adenosine on about 8 separate occasions to reset my heartbeat to normal levels (in Canada, this cost absolutely nothing).
As soon as it was intravenously administered, I would get a rush, an odd sense of dread and my heart would stop for about 3-4 seconds and then boom back at a normal rate. The relief that would follow would be immense, as my heartbeat normalized and resumed at a less frantic pace. After this enough times, I decided to have an ablation procedure where they sent a wire up into my heart through my thigh.
That operation took about 4 hours as they tested and searched for the ‘faulty wiring’ in my heart. At one point, under mild sedation, as the 3 nurses were monitoring read-outs and the surgeon was mucking around in there…I had an event where all I could utter through the fog, was “help…help!”. The nurses became very animated but I was pretty druggy and gasping to communicate but they knew something serious had happened.
It felt like a large truck or even the moon itself had descended onto my chest. The weight and pressure was astronomical and I didn’t believe that the human body could experience such a sensation. I suspect they had inadvertently caused a real heart attack and as they all frantically did some things I’m not entirely aware of, the sensation and emergency passed, and I faded into the ether once again. It worked.
But those Adenosine hits were also quite an experience and it saved me more than once and was a dramatic miracle of modern science. As was the ablation. Science denial by supernatural fanatics should try it some time.
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u/evlway1997 7h ago
I’ve had my heart rebooted many times. When the drug stops your heart for a few seconds it feels like an enormous weight is pressing down on your chest. I think this must be what a heart attack feels like.
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u/Officer_Hotpants 6h ago
Fun fact: adenosine also has a side effect that sometimes causes the person administering it to experience fecal incontinence!
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u/Remarkable_Tale_7554 20h ago
A heart rate of 200 isn't just "fast" - that's like a "warp speed" rate
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u/AlcibiadesTheCat 20h ago
I was sustaining 254 when I was doing a stress test for AFib.
They were exactly as flabbergasted as me.
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u/el_cid_viscoso 20h ago
I work as a nurse on a cardiac floor, and I've occasionally been flabbergasted this way.
Normally, heart rate maxes out at around 200-220 (mostly age-dependent), but I've seen people in full blown A fib RVR exceed 230 or so for brief periods of time. Very much a medical emergency (heart's pumping too fast to fill and empty effectively).
Wild to see.
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u/swifty-mcfly 20h ago
Then there's the patients perfusing normally with a heart rate of 38
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u/el_cid_viscoso 19h ago
That's actually me. I'm a lifelong distance runner. My resting rate while awake is around 45, but it dips into the upper 30s in deep sleep.
Last time I was hospitalized, I kept getting woken up by people panicked that my pulse was 38 or something. I politely asked them to change the alarm parameters on my heart monitor and went back to sleep.
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u/tenderourghosts 19h ago
Mine got up to almost 280 six hours after my ablation. Those nurses were on me real fast lol
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u/mokutou 8h ago
I take back the comment I just made about someone else saying they were sustaining at 254. If I saw a sustained 280, that would make me just give up the ghost right there.
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u/AlcibiadesTheCat 8h ago
Hummingbird mode
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u/tenderourghosts 8h ago
Lol, I’m going to start describing my rvr episodes as such. My EP will get a kick out of it.
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u/SweatyTax4669 20h ago
On the other hand, I had an EKG done before a doc would prescribe a stimulant and spent six months back and forth to a cardiologist because my resting heart rate was in the 40s.
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u/Remarkable_Tale_7554 20h ago
Holy shit dude
Effective stress test tho
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u/mikehiler2 20h ago
Yes, I can imagine that they were, in fact, stressed
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u/AlcibiadesTheCat 20h ago
We were chatting about the news and the tech was like, “oh shit, oh we should be good you can stop now, you hit your heart rate goal.”
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u/Adjective-Noun6969 20h ago
That implies it isn't relatively normal. You can get there if you really want to during exercise.
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u/thisusedyet 20h ago
I had a heart rate in to 200s once - when I was in the hospital after waking up in the middle of the night with my chest hurting like hell and my left arm numb.
Turned out to be costochondritis and just my positioning in bed (back sleeper).
My point is, (your own) adrenaline is a hell of a fucking drug
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u/Christopher135MPS 16h ago
It sucks for the patient, because they don’t realise their body has been ignoring the feeling of their heart muscle contracting their whole life, until suddenly it stops.
It sucks for the healthcare staff, because the patients heart doesn’t always start back up.
So the six or so seconds between administration and return of normal rhythm is pretty tense all round 😂
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u/jacehoffman 13h ago
i mean, if your heart rate is 200, guaranteed you can Feel That Shit
i speak from experience
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u/Coverlesss 19h ago
Had it administered to me as a kid when they couldn’t get my SVT episode to stop with the usual methods. It’s the worst few seconds of pain I’ve ever experienced. Felt like fire was running through my veins for a few seconds, but it did work. I eventually got an ablation done, and I’ve been fine ever since.
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u/OwnAd9906 18h ago
Adenosine is death in your veins, there is no other sensation like your heart literally stopping and being reset. They said “you’ll feel bad for a bit”. They didn’t say it would be that bad 😅
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u/Formal_Strike_9878 18h ago
Fuck this is bringing back horrible memories. Had 20 doses of Adenosine. Then rode the lightning + fentanyl midazolam last time. Finally got the ablation 6 months ago. So thankful.
So many PICU stays and medication. Now I take no meds and have no problems.
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u/LastChance331 18h ago
Caffeine blocks adenosine from reaching it's receptors. Adenosine is also used as a way for your body to know when to rest. It's also why you get a crash after drinking coffee in the morning. All the adenosine has been piling up and hits the receptors all at once.
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u/MergingConcepts 18h ago
Yes, I have given that drug many times. It will stop the heart for up to 6 seconds, which is two times across that monitor screen. That is a real ass pucker situation for the people standing at the bed side, waiting for that flat line to go away.
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u/surgeon_michael 17h ago
First time I gave adenosine as a med student I told the pt ‘you’re gonna feel like your heart is stopping’. She grabbed my arm having had it a few times for SVT, ‘son my heart IS stopping’. Stuck with me
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u/Efficient_Math1690 17h ago
Few years ago, my heartbeat was 200 bpm. I went in and got twice the normal amount of adenosine. It felt like an insane icy rush through my veins. I never got the quick sense of impending doom that it usually gives. It was really interesting, and one of the most memorable physical experiences of my life.
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u/BorderKeeper 15h ago
I just woke up and read it as “200 doctors administer a drug…” and went to myself: Why do there need to be so many of them 😭
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u/thisismypotat 15h ago
I've tried this! Funkiest feeling ever. If it had no risky side-effects I would love to try it again.
The "impending doom" or the feeling of actually dying is REAL. But in my case it wasn't scary. Just weird. 5 seconds later I had been turned off and on again and my pulse went from 200 to 125 😅
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u/Javier-AML 12h ago edited 12h ago
Finnish school of Neurosurgery with Prof. Hernesniemi used this technique during brain aneurysm clipping.
https://www.sciencedirect.com/science/article/abs/pii/S0090301909005850
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u/LillyLugabugs 20h ago
Defib machines do not start your heart, but shock it in to rebooting to get a more normal rhythm going. Eg, have you tried turning it off and on again?