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Published on: September 24, 2021
Aminophylline for prevention of bradyarrhythmias induced by rheolytic thrombectomy
Augustin DeLago1, Mohammad El-Hajjar, Mikhail Kirnus
1Albany Medical Center, Department of Cardiology, 43 New Scotland Avenue, Room C-716, MC15, Albany, NY 12208, USA. DeLagoA@mail.amc.edu
Insights
Aminophylline may prevent bradyarrhythmias during rheolytic thrombectomy for acute myocardial infarction. This study explored its use in preventing cardiac rhythm disturbances associated with the AngioJet system.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Coronary thrombus in ST-elevation myocardial infarction poses challenges during percutaneous coronary intervention (PCI).
- Thrombectomy aims to remove thrombus before PCI, potentially improving outcomes.
- Rheolytic thrombectomy, using systems like AngioJet, can cause transient bradyarrhythmias requiring pacing.
Purpose of the Study:
- To evaluate the efficacy of aminophylline in preventing bradyarrhythmias associated with rheolytic thrombectomy.
- To assess the safety and effectiveness of aminophylline as a prophylactic agent in this context.
Main Methods:
- A single tertiary care center retrospective analysis.
- Administration of aminophylline prior to rheolytic thrombectomy.
- Monitoring for cardiac rhythm disturbances and need for temporary pacing.
Main Results:
- Aminophylline was used as a sole agent to prevent bradyarrhythmias.
- The report details the clinical observations from its use in this specific setting.
Conclusions:
- Aminophylline may serve as a preventive measure against rheolytic thrombectomy-induced bradyarrhythmias.
- Further prospective studies are warranted to confirm these findings and establish optimal protocols.
Abstract:
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.
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