Document Detail


Theophylline for the treatment of atrioventricular block after myocardial infarction.
MedLine Citation:
PMID:  7661495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To show that second- or third-degree atrioventricular block occurring as an early complication of acute inferior myocardial infarction is mediated by adenosine. SETTING: Cardiac care unit. DESIGN: Uncontrolled, observational, hypothesis-driven study. PATIENTS: Patients who developed clinically significant atrioventricular nodal blockade within 4 hours of admission for acute inferior myocardial infarction. INTERVENTION: Theophylline, 100 mg/min intravenously to a maximum of 250 mg. MEASUREMENTS: Continuous multilead electrocardiographic monitoring before and after administration of theophylline. RESULTS: During a 6-month period, eight men who had had acute inferior myocardial infarction developed clinically significant atrioventricular block. Three had third-degree block, and five had high-grade second-degree block. In all patients, 1:1 atrioventricular nodal conduction was restored and normal sinus rhythm reappeared within 3 minutes of the administration of theophylline. All patients remained free of arrhythmia for at least 24 hours. CONCLUSIONS: Adenosine produced by the ischemic myocardium may induce atrioventricular nodal block. In our patients, atrioventricular nodal block was resistant to conventional therapy such as atropine, but it responded to the adenosine antagonist theophylline.
Authors:
B D Bertolet; E B McMurtrie; J A Hill; L Belardinelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  123     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-10-04     Completed Date:  1995-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  509-11     Citation Subset:  AIM; IM    
Affiliation:
University of Florida Health Sciences Center, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / antagonists & inhibitors*,  physiology
Adult
Aged
Electrocardiography
Heart Block / drug therapy*,  etiology,  physiopathology
Humans
Male
Middle Aged
Monitoring, Physiologic
Myocardial Infarction / complications*
Theophylline / therapeutic use*
Chemical
Reg. No./Substance:
58-55-9/Theophylline; 58-61-7/Adenosine
Comments/Corrections
Comment In:
Ann Intern Med. 1996 Sep 1;125(5):421   [PMID:  8702099 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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