A 27 year-old man presents with a rapid narrow complex tachycardia. He receives adenosine 6 mg IV. The presenting tachycardia is terminated. However, 45 seconds later, he develops rapid atrial fibrillation.

Which of the following possible actions of adenosine is most likely to be responsible for developing atrial fibrillation?

  1. Decreased intracellular cyclic AMP.
  2. Prolonged phase 3 repolarization.
  3. Block of AV nodal conduction.
  4. Shortened atrial action potential duration.
  5. Hypoxia due to bronchospasm.
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