title: Prophylactic Atropine Administration Prevents Vasovagal Response Induced by Cryoballoon Ablation in Patients with Atrial Fibrillation.
abstract: BACKGROUND
  Cryoballoon (CB) ablation of pulmonary vein ostia often induces a vagal response. This prospective study was designed to assess the effectiveness of prophylactic intravenous administration of atropine on hemodynamic impairment induced by CB ablation in patients with atrial fibrillation.
  
  
  METHODS
  Twenty-five patients with paroxysmal atrial fibrillation undergoing CB ablation were prospectively enrolled and assigned to one of two groups. First 12 patients (trial group) were administered 1 mg of atropine before deflation of the CB, while the following 13 patients (control group) were given atropine only after the onset of the hemodynamic variation (decrease in heart rate and/or blood pressure). Treatment was considered effective when the hemodynamic variations were restored.
  
  
  RESULTS
  In the trial group, three patients with transient hypotension did not require supportive care throughout the procedures, and one patient with hypotension required supportive care. In the control group, hypotension, bradycardia, and mixed bradycardia with hypotension requiring supportive care occurred in six, three, and three patients, respectively. Overall, the rate of marked vagal responses was significantly lower when prophylactic atropine was administrated (4/12 patients vs 12/13 patients, respectively; P < 0.01).
  
  
  CONCLUSIONS
  Atropine is significantly effective in the prevention of all types of vasovagal responses induced by CB ablation in patients with atrial fibrillation.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: DU
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Songnan
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Salim
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000889:Anti-Arrhythmia Agents; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D001285:Atropine / Q000008:administration & dosage*; D017115:Catheter Ablation / Q000009:adverse effects*; D003452:Cryosurgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000379:methods*; D019462:Syncope, Vasovagal / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D001285:Atropine
keywords: atrial fibrillation; atropine; cryoballoon; vasovagal response