title: Recovery of Ventriculo-Atrial Conduction after Adrenaline in Patients Implanted with Pacemakers.
abstract: BACKGROUND
  Ventriculo-atrial (VA) conduction can have negative consequences for patients with implanted pacemakers and defibrillators. There is concern whether impaired VA conduction could recover during stressful situations. Although the influence of isoproterenol and atropine are well established, the effect of adrenaline has not been studied systematically. The objective of this study was to determine if adrenaline can facilitate recovery of VA conduction in patients implanted with pacemakers.
  
  
  METHODS
  A prospective study was conducted on 61 consecutive patients during a 4-month period (April-July 2014). The presence of VA conduction was assessed during the pacemaker implantation procedure. In case of an impaired VA conduction, adrenaline infusio was used as a stress surrogate to test conduction recovery.
  
  
  RESULTS
  The indications for pacemaker implantation were: sinus node dysfunction in 18 patients, atrioventricular (AV) block in 40 patients, binodal dysfunction (sinus node+ AV node) in two patients and other (carotid sinus syndrome) in one patient. In the basal state, 15/61 (24.6%) presented spontaneous VA conduction and 46/61 (75.4%) had no VA conduction. After administration of adrenaline, there was VA conduction recovery in 5/46 (10.9%) patients.
  
  
  CONCLUSIONS
  Adrenaline infusion produced recovery of VA conduction in 10.9% of patients with absent VA conduction in a basal state. Recovery of VA conduction during physiological or pathological stresses could be responsible for the pacemaker syndrome, PMT episodes, or certain implantable cardiac defibrillator detection issues.
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Gabriel
authors: G
authors: Cismaru
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Gabriel
authors: G
authors: Gusetu
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Lucian
authors: L
authors: Muresan
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Radu
authors: R
authors: Rosu
authors: CHU de Nancy, Department of Cardiology, University Hospital Nancy, France.
authors: Marius
authors: M
authors: Andronache
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Roxana
authors: R
authors: Matuz
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Mihai
authors: M
authors: Puiu
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Petru
authors: P
authors: Mester
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Maria
authors: M
authors: Miclaus
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Dana
authors: D
authors: Pop
authors: Department of Gastroenterology, Medical Clinic No 1, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Petru Adrian
authors: PA
authors: Mircea
authors: Department of Cardiology, Rehabilitation Hospital, University of Medicine and Pharmacy "IuliuHatieganu," Cluj-Napoca, Romania.
authors: Dumitru
authors: D
authors: Zdrenghea
mesh_terms: D000368:Aged; D054537:Atrioventricular Block / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011292:Premedication / Q000379:methods*; D019919:Prosthesis Implantation; D020127:Recovery of Function; D013566:Sympathomimetics / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013566:Sympathomimetics; D004837:Epinephrine
keywords: ICD; adrenaline; endless loop tachycardia; pacemaker syndrome; ventriculoatrial conduction