A mix of aminophylline and heparin plus nitroglycerin can reduce bradycardia during rotational atherectomy on the right coronary artery and dominant circumflex artery.
Herz
; 48(6): 480-486, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-37401989
ABSTRACT
BACKGROUND:
Rotational atherectomy (RA) may cause bradyarrhythmias and transitory atrioventricular block when performed in the right coronary artery (RCA) or a dominant circumflex (CX) coronary artery. However, there are no studies of a solution that can prevent coronary flow deterioration and bradycardia complications that may occur during RA. We aimed to create an alternative rota-flush solution to minimize the risk of bradycardia and complete atrioventricular block (AVB) that can occur during RA. MATERIALS ANDMETHODS:
The study comprised 60 patients who were randomly divided into two groups 30 received rotaphylline (=â¯240â¯mg aminophylline, 10,000 U unfractionated heparin, and 2000â¯mcg nitroglycerin to 1000â¯mL saline), and 30 received the traditional rota-flush (=â¯10,000 U unfractionated heparin, 2000â¯mcg nitroglycerin, and 1000â¯mL saline). The incidence of bradycardia or high-grade AVB (HAVB) during RA, coronary slow-flow phenomenon or no-reflow phenomenon, and coronary spasm were the primary endpoints of the study. Procedure success and RA-related procedural complications were secondary endpoints.RESULTS:
The use of rotaphylline was an independent predictor of bradycardia and HAVB after accounting for all other factors (OR 0.47, 95% CI 0.24-0.79, pâ¯< 0.001). Lesion length (OR 2.17, 95% CI 1.24-3.04, pâ¯< 0.001), burr-to-artery ratio (OR 0.59, 95% CI 0.39-1.68, pâ¯< 0.001), and total run duration (OR 0.79, 95% CI 0.35-1.43, pâ¯< 0.001) were additional independent predictors.CONCLUSION:
Bradycardia and the development of HAVB may be avoided by rotaphylline intracoronary infusion during RA applied to the RCA and dominant CX lesions. Multicenter studies including sizable patient populations should be conducted to validate the present findings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Aterectomia Coronária
/
Bloqueio Atrioventricular
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Herz
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Turquia