Effects of oral theophylline on sick sinus syndrome.
OBJECTIVE
We sought to determine the effect of theophylline on cardiac pauses in sick sinus syndrome.


BACKGROUND
Sick sinus syndrome, a relatively benign condition, is usually treated with pacemaker implantation without any proved effectiveness. Thus, an appropriate pharmacologic therapy would be useful.


METHODS
Theophylline (200 to 400 mg/day for 1 month) was initially administered orally to 17 patients with sick sinus syndrome, which is manifested by sinus pauses of > 2.5 s. Eleven of the 17 patients subsequently received theophylline for an additional 8 to 37 months. Twenty-four-hour Holter recordings were obtained before treatment, at the end of 1 month of treatment and then at 6-month intervals.


RESULTS
Theophylline decreased the frequency of sinus pauses from 256 +/- 230 to 23 +/- 62 pauses per 24 h and decreased the duration of the longest pauses from 4.7 +/- 1.8 to 2.2 +/- 0.97 s after 1 month of treatment. Subjective symptoms associated with cardiac pauses disappeared in 16 of 17 patients. Ventricular premature beats increased in frequency but did not last longer than two beats. Three patients experienced adverse effects. Nine of the 11 patients receiving long-term treatment had a good outcome, but 2 patients required a pacemaker because of the reappearance of long sinus pauses.


CONCLUSIONS
The results suggest that oral theophylline may be beneficial for the treatment of patients with sick sinus syndrome.
Saito
D
D
Department of Cardiovascular Medicine, Okayama University Medical School, Japan.
Matsubara
K
K
Yamanari
H
H
Obayashi
N
N
Uchida
S
S
Maekawa
K
K
Sato
T
T
Mizuo
K
K
Kobayashi
H
H
Haraoka
S
S
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004341:Drug Evaluation; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012804:Sick Sinus Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D013806:Theophylline / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D013806:Theophylline