Can glycopyrrolate replace temporary pacemaker and atropine in patients at high risk for symptomatic bradycardia undergoing AngioJet mechanical thrombectomy?
We studied the feasibility and efficacy of glycopyrrolate, a synthetic anticholinergic agent with shorter half-life and without reflex tachycardia, in preventing symptomatic bradycardia in patients undergoing mechanical thrombectomy with the AngioJet Rheolytic Thrombectomy System (Possis Medical, Inc., Minneapolis, Minnesota). There was no need for temporary pacemaker insertion and no hemodynamically significant bradycardia in 10 consecutive patients. Additionally, there were no adverse effects from glycopyrrolate therapy. Our pilot study demonstrates that glycopyrrolate may replace temporary pacemaker insertion in these patients at high risk for symptomatic bradycardia.
Syed
Tariqshah
T
Cardiac Catheterization Laboratory & Interventional Cardiology, St. Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
Tamis-Holland
Jacqueline
J
Coven
David
D
Hong
Mun K
MK
D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001285:Atropine / Q000008:administration & dosage*; D001919:Bradycardia / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006024:Glycopyrrolate / Q000009:adverse effects*; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010138:Pacemaker, Artificial; D010865:Pilot Projects; D017131:Thrombectomy / Q000009:adverse effects*; D013997:Time Factors
D000889:Anti-Arrhythmia Agents; D018727:Muscarinic Antagonists; D001285:Atropine; D006024:Glycopyrrolate