Paroxysmal AV block Theophylline
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Overview
Theophylline is an adenosine antagonist that may be used in the diagnosis of extrinsic vagal paroxysmal AV Block.
Theophylline
- Theophylline is a non-selective adenosine antagonist that may be employed in the treatment of EI-AVB.
- It exerts a positive chronotropic and dromotropic effect.
- A study conducted by Benditt et al showed that theophylline shortened the minimum atrial paced cycle length, maintained 1:1 AV conduction and consistently reduced AV node functional refractory periods. [1]
- In two small observational studies, oral theophylline appeared to be effective over a mean follow-up of 16 and 17 months in patients with an established diagnosis of EI-AVB and may be considered an alternative to permanent pacing in such patients.
- No studies on the role of theophylline in I-AVB are available.
- A few small observational studies on patients with EV-AVB treated with theophylline have recorded a recurrence rate ranging between 12% and 22%.
- In a randomized controlled trial,theophylline proved ineffective in preventing reflex syncope in patients affected by sick sinus syndrome compared with the not treatment arm. "Syncope and paroxysmal atrioventricular block - Aste - 2017 - Journal of Arrhythmia - Wiley Online Library".
References
- ↑ Benditt DG, Benson DW, Kreitt J, Dunnigan A, Pritzker MR, Crouse L; et al. (1983). "Electrophysiologic effects of theophylline in young patients with recurrent symptomatic bradyarrhythmias". Am J Cardiol. 52 (10): 1223–9. doi:10.1016/0002-9149(83)90578-7. PMID 6359850.