| A comparison of the chronotropic and dromotropic actions between adenosine triphosphate and edrophonium in patients undergoing coronary artery bypass graft surgery. | |
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MedLine Citation:
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PMID: 12407613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the effects of the stimulation of adenosine receptors and acetylcholine receptors in the cardiac conduction system in patients with ischemic heart disease. DESIGN: Prospective. SETTING: University hospital. PARTICIPANTS: Patients scheduled for coronary artery bypass graft surgery (n = 37). INTERVENTIONS: The patients were divided into 3 groups: control group (n = 9), adenosine triphosphate (ATP) group (n = 12), and edrophonium group (n = 16). ATP (10 mg) or edrophonium (0.25 mg/kg) followed by saline or the same amount of saline was injected through a central venous catheter. MEASUREMENTS AND MAIN RESULTS: ATP induced atrioventricular block in 10 of 12 patients (83%). The ATP injection produced a more prominent prolongation in the PQ duration (P-R interval) (139%) than in the P-P interval (105%) at the last beat before the development of atrioventricular block. The prolongation in the P-P interval (11%, average 85 msec) and PQ duration during atrioventricular block disappeared immediately after the restoration of atrioventricular conduction. After edrophonium, the maximal prolongation in P-P (118%, p < 0.01) and PQ (120%, p < 0.01) intervals was the same. P-P interval remained prolonged (p < 0.01) after PQ interval returned to baseline. Neither ATP nor edrophonium affected the QRS duration. CONCLUSION: These findings suggest that ATP predominantly inhibited atrioventricular conduction rather than the firing rate of sinoatrial nodes, and edrophonium inhibited both proportionally even with prolonged inhibitory action on the sinoatrial nodes. An injection of ATP is needed only when a transient cardiac standstill is requested, such as in endovascular grafting surgery. Edrophonium may be used to slow heart rate during coronary artery bypass graft surgery. |
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Authors:
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Seiji Watanabe; Yasuo Kono; Yoko Oishi-Tobinaga; Shin-ichi Yamada; Masato Hara; Tatsuhiko Kano |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 16 ISSN: 1053-0770 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2002 Oct |
Date Detail:
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Created Date: 2002-10-30 Completed Date: 2003-01-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 598-602 Citation Subset: IM |
Copyright Information:
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Copyright 2002, Elsevier Science (USA). All rights reserved. |
Affiliation:
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Department of Anesthesiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan. watanabe@med.kurume-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine Triphosphate
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pharmacology* Adult Aged Atrioventricular Node / drug effects*, physiology Coronary Artery Bypass* Edrophonium / pharmacology* Electrocardiography / drug effects Heart Block / chemically induced Heart Rate / drug effects* Humans Middle Aged Prospective Studies |
| Chemical | |
Reg. No./Substance:
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312-48-1/Edrophonium; 56-65-5/Adenosine Triphosphate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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