Complete Heart Block, Inferior Wall Myocardial Infarction
Conditions
Brief summary
In this study, the investigator will evaluate the rate of reversal of complete heart block with aminophylline in atropine resistant patients with inferior wall myocardial infarction (MI)
Detailed description
Administration of Aminophylline can result in reversal of complete heart block in a significant number of atropine resistant patients with inferior wall MI. Hence, in this study our primary aim is to evaluate the rate of reversal of complete heart block with aminophylline in atropine resistant patients with inferior wall MI.
Interventions
DRUGAminophylline Injection
Injection Aminophylline IV 240 mg will be given over 10 minutes. After 1 hour, Aminophylline 240 mg second dose will be given over 10 minutes.
Sponsors
National Institute of Cardiovascular Diseases, Pakistan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
An Open Label Non-randomized Clinical Trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients admitted with recent acute inferior wall myocardial infarction (MI) * Hemodynamically stable blood pressure * Complete heart block with Narrow QRS \< 120 ms and ventricular rate \>40/min persisting for at least 6 hours, resistant to atropine * Temporary pacemaker (TPM) already placed * Patient asymptomatic with a mean arterial pressure of greater than 65 mmHg with TPM rate placed at 40/min
Exclusion criteria
* Patients with cardiogenic shock * Patients with preexisting permanent pacemaker and Implantable Cardioverter Defibrillator (ICD). * Patients with a prior history of AV block * Drugs with dromotropic effects (beta blocker, calcium channel blocker, inotropes) * Known liver disease (cirrhosis, hepatitis) * Hypothyroidism * Unable to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Reversal of complete heart block | Within 1 hour of 2nd dose | Conversion to sinus rhythm with 1:1 conduction |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improved conduction | Within 1 hour of 2nd dose | Combined end point of 1:1 conduction and improved conduction to second degree AV block |
| Major adverse cardiac events (MACE) | Within 12 hours | Ventricular arrhythmias ( VT more than 3 beats), decrease in ventricular escape rate requiring increasing pacing rate, cardiac arrest or death |
Outcome results
None listed