BRIEF REPORTS
Effects of Aminophylline with Late Atrioventricular Myocardial Infarction
on Atrioventricular Conduction in Patients Block During Inferior Wall Acute
Boris Strasberg, MD, Rony Bassevich, MD, Aviv Mager, MD, Jairo Kusniec, MD, Alex Sagie, MD, and Samuel Sclarovsky, MD Inferior AMI was diagnosed by the triad of typical chest pain lasting >20 minutes, evolutionary ST-T changes with development of pathologic Q waves in the dial infarction (AMI). This report examinesthe effect of inferior leads ana’ an increase in serum cardiac enzymes. aminophylline on AV block in a large group of patients Aminophylline was giL)en as a loading dose of 7 mgjkg infused over 20 minutes (serum levels were not meawith inferior AMI. sured). Patients were monitored throughout the infusion Fifteen consecutive patients with inferior wall AMI who developed second-degree or complete AVblock were period. Electrocardiographic rhythm strips were obtained before and 5 minutes after drug administration included in this study (Table I). Patients had to maintain a stable AVblock rhythm for at least 1 hour before and the type of AV block and the atria1 and ventricular aminophylline administration. Patients with AV block rate noted. Blood pressure was monitored by arm cuff. There were 11 men and 4 women whose ages ranged who were receiving drugs known to depress AV nodal conduction were excluded (e.g., digitalis, B blockers, cal- from 52 to 85 years (mean 71 f 8). AV block was late cium channel blockers, amiodarone). Patients who de- in appearance (by protocol) in all patients, starting 2 to 6 veloped AV block during the hyperacute phase of the days after the hyperacute stage of AMI. The type of AV block was of second-degree Wenckebach type in 5 painferior AMI were also excluded because this earlytients, 2:l AV block in 6 patients and complete in 4 appearing A V block in our experience tends to disappear abruptly and rapidly parallel to the disappearance of patients. All patients had narrow QRS complexes. At the time of aminophylline administration only 2 patients the superacute ischemia. Therefore, only patients with had a temporary pacemaker installed. In both, thepace“late” block were included.17 maker was switched off for the hour of observation before and throughout the time of drug administration. From the Coronary Care Unit, Beilinson Medical Center, Petah Tiqva The mean sinus rate before aminophylline was 90 f and Sackler School of Medicine, Petah Tiqva 49100, Tel Aviv Universi11 beats/min and decreased to 85 f 13 after drug adminty, Israel. Manuscript received August 21, 1990; revised manuscript istration (p
Effects of Aminophylline with Late Atrioventricular Myocardial Infarction
on Atrioventricular Conduction in Patients Block During Inferior Wall Acute
Boris Strasberg, MD, Rony Bassevich, MD, Aviv Mager, MD, Jairo Kusniec, MD, Alex Sagie, MD, and Samuel Sclarovsky, MD Inferior AMI was diagnosed by the triad of typical chest pain lasting >20 minutes, evolutionary ST-T changes with development of pathologic Q waves in the dial infarction (AMI). This report examinesthe effect of inferior leads ana’ an increase in serum cardiac enzymes. aminophylline on AV block in a large group of patients Aminophylline was giL)en as a loading dose of 7 mgjkg infused over 20 minutes (serum levels were not meawith inferior AMI. sured). Patients were monitored throughout the infusion Fifteen consecutive patients with inferior wall AMI who developed second-degree or complete AVblock were period. Electrocardiographic rhythm strips were obtained before and 5 minutes after drug administration included in this study (Table I). Patients had to maintain a stable AVblock rhythm for at least 1 hour before and the type of AV block and the atria1 and ventricular aminophylline administration. Patients with AV block rate noted. Blood pressure was monitored by arm cuff. There were 11 men and 4 women whose ages ranged who were receiving drugs known to depress AV nodal conduction were excluded (e.g., digitalis, B blockers, cal- from 52 to 85 years (mean 71 f 8). AV block was late cium channel blockers, amiodarone). Patients who de- in appearance (by protocol) in all patients, starting 2 to 6 veloped AV block during the hyperacute phase of the days after the hyperacute stage of AMI. The type of AV block was of second-degree Wenckebach type in 5 painferior AMI were also excluded because this earlytients, 2:l AV block in 6 patients and complete in 4 appearing A V block in our experience tends to disappear abruptly and rapidly parallel to the disappearance of patients. All patients had narrow QRS complexes. At the time of aminophylline administration only 2 patients the superacute ischemia. Therefore, only patients with had a temporary pacemaker installed. In both, thepace“late” block were included.17 maker was switched off for the hour of observation before and throughout the time of drug administration. From the Coronary Care Unit, Beilinson Medical Center, Petah Tiqva The mean sinus rate before aminophylline was 90 f and Sackler School of Medicine, Petah Tiqva 49100, Tel Aviv Universi11 beats/min and decreased to 85 f 13 after drug adminty, Israel. Manuscript received August 21, 1990; revised manuscript istration (p
