Paroxysmal AV block Theophylline: Difference between revisions
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==Overview== | ==Overview== | ||
Theophylline is an adenosine antagonist that may be used in the diagnosis of extrinsic vagal paroxysmal AV Block. | [[Theophylline]] is an [[adenosine]] [[antagonist]] that may be used in the diagnosis of extrinsic [[vagal]] [[paroxysmal AV Block]]. | ||
==Theophylline== | ==Theophylline== | ||
*Theophylline is a '''non-selective adenosine antagonist''' that may be employed in the treatment of EI-AVB. | *[[Theophylline]] is a '''non-selective [[adenosine]] [[antagonist]]''' that may be employed in the treatment of EI-AVB. | ||
*It exerts a '''positive chronotropic and dromotropic effect'''. | *It exerts a '''positive [[chronotropic]] and [[dromotropic]] effect'''. | ||
*'''A study conducted by Benditt et al''' showed that theophylline shortened the minimum atrial paced cycle length, maintained 1:1 AV conduction and consistently reduced AV node functional refractory periods. <ref name="pmid6359850">{{cite journal| author=Benditt DG, Benson DW, Kreitt J, Dunnigan A, Pritzker MR, Crouse L | display-authors=etal| title=Electrophysiologic effects of theophylline in young patients with recurrent symptomatic bradyarrhythmias. | journal=Am J Cardiol | year= 1983 | volume= 52 | issue= 10 | pages= 1223-9 | pmid=6359850 | doi=10.1016/0002-9149(83)90578-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6359850 }} </ref> | *'''A study conducted by Benditt et al''' showed that [[theophylline]] shortened the minimum [[atrial]] paced cycle length, maintained 1:1 [[AV]] conduction and consistently reduced [[AV node]] functional refractory periods. <ref name="pmid6359850">{{cite journal| author=Benditt DG, Benson DW, Kreitt J, Dunnigan A, Pritzker MR, Crouse L | display-authors=etal| title=Electrophysiologic effects of theophylline in young patients with recurrent symptomatic bradyarrhythmias. | journal=Am J Cardiol | year= 1983 | volume= 52 | issue= 10 | pages= 1223-9 | pmid=6359850 | doi=10.1016/0002-9149(83)90578-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6359850 }} </ref> | ||
*In two small observational | *In two small [[observational studie]]s, '''[[oral]] [[theophylline]] appeared to be effective over a [[mean]] follow-up of 16 and 17 months in patients with an established diagnosis of EI-AVB''' and '''may be considered an alternative to permanent [[pacing]] in such patients'''. | ||
*No studies on the role of theophylline in I-AVB are available. | *No studies on the role of theophylline in I-AVB are available. | ||
*A few small observational studies on patients with EV-AVB treated with theophylline have recorded a recurrence rate ranging between 12% and 22%. | *A few small [[observational studies]] on patients with EV-AVB treated with [[theophylline]] have recorded a [[recurrence rate]] ranging between 12% and 22%. | ||
*In a randomized controlled trial, theophylline proved ineffective in preventing reflex syncope in patients affected by sick sinus syndrome compared with the not treatment arm. {{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1016/j.joa.2017.03.008 |title=Syncope and paroxysmal atrioventricular block - Aste - 2017 - Journal of Arrhythmia - Wiley Online Library |format= |work= |accessdate=}} | *In a [[randomized controlled trial]],[[theophylline]] proved ineffective in preventing [[reflex]] [[syncope]] in patients affected by [[sick sinus syndrome]] compared with the not [[treatment]] arm. {{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1016/j.joa.2017.03.008 |title=Syncope and paroxysmal atrioventricular block - Aste - 2017 - Journal of Arrhythmia - Wiley Online Library |format= |work= |accessdate=}} | ||
==References== | ==References== | ||
Latest revision as of 14:06, 4 July 2020
Overview
Theophylline is an adenosine antagonist that may be used in the diagnosis of extrinsic vagal paroxysmal AV Block.
Theophylline
- Theophylline is a non-selective adenosine antagonist that may be employed in the treatment of EI-AVB.
- It exerts a positive chronotropic and dromotropic effect.
- A study conducted by Benditt et al showed that theophylline shortened the minimum atrial paced cycle length, maintained 1:1 AV conduction and consistently reduced AV node functional refractory periods. [1]
- In two small observational studies, oral theophylline appeared to be effective over a mean follow-up of 16 and 17 months in patients with an established diagnosis of EI-AVB and may be considered an alternative to permanent pacing in such patients.
- No studies on the role of theophylline in I-AVB are available.
- A few small observational studies on patients with EV-AVB treated with theophylline have recorded a recurrence rate ranging between 12% and 22%.
- In a randomized controlled trial,theophylline proved ineffective in preventing reflex syncope in patients affected by sick sinus syndrome compared with the not treatment arm. "Syncope and paroxysmal atrioventricular block - Aste - 2017 - Journal of Arrhythmia - Wiley Online Library".
References
- ↑ Benditt DG, Benson DW, Kreitt J, Dunnigan A, Pritzker MR, Crouse L; et al. (1983). "Electrophysiologic effects of theophylline in young patients with recurrent symptomatic bradyarrhythmias". Am J Cardiol. 52 (10): 1223–9. doi:10.1016/0002-9149(83)90578-7. PMID 6359850.