Aminophylline for prevention of bradyarrhythmias induced by rheolytic thrombectomy.
In patients with acute ST-elevation myocardial infarction or in those with thrombus-containing lesions, percutaneous coronary intervention (PCI) represents a clinical challenge to the interventionist, because coronary thrombus is a predictor of adverse outcomes. Thrombectomy, or the removal of thrombusfrom the infarct-related vessel prior to PCI, might improve clinical outcomes. The AngioJet Rheolytic Thrombectomy System (Possis Medical, Inc., Minneapolis, Minnesota) is commonly used to treat lesions containing thrombus burden. A complication of rheolytic thrombectomy is transient cardiac rhythm disturbances, specifically bradyarrhythmia requiring temporary pacing. Aminophylline, a methylxanthine and a competitive inhibitor of the adenosine receptor, may prevent rheolytic thrombectomy-associated bradyarrhythmias. This report describes the use of aminophylline alone to prevent rheolytic thrombectomy-induced bradyarrhythmias in a single tertiary care center.
DeLago
Augustin
A
Albany Medical Center, Department of Cardiology, 43 New Scotland Avenue, Room C-716, MC15, Albany, NY 12208, USA. DeLagoA@mail.amc.edu
El-Hajjar
Mohammad
M
Kirnus
Mikhail
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000628:Aminophylline / Q000627:therapeutic use*; D015906:Angioplasty, Balloon, Coronary; D001919:Bradycardia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003328:Coronary Thrombosis / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects*
D002316:Cardiotonic Agents; D000628:Aminophylline