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European Heart Journal 1991 12(5):630-634;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Dromotropic effects of oral theophylline in patients with atrial fibrillation and a slow ventricular response

P. ALBONI*,, B. RATTO{dagger}, S. SCARFO*, P. ROSSI{dagger}, R. CAPPATO* and N. PAPARELLA*

*Division of Cardiology, S.Anna Hospital Genova, Italy
{dagger}Ferrara and Division of Cardiology, S.Martino Hospital Genova, Italy

Received 30 October 1989; revised 29 June 1990; .

Correspondence: Dr Paolo Alboni, Division of Cardiology, S.Anna Hospital, 44100 Ferrara, Italy

Abstract

Theophylline increases sinus rate, but as yet its use has not been investigated in patients with chronic atrio ventricular conduction disturbances. Resting electrocardiogram, 24-h Holter recording and treadmill test were performed in 17 patients with chronic atrialfibrillation and a slow ventricular response not related to drugs (age: 75±8 years). Then slow-release theophylline was administered (700mg daily) and after 5 days these investigations were repeated with the same methods. Theophylline increased mean resting heart rate (51±6 versus 67±13 beats.min–1, P<0·01 mean 24-h heart rate (51±6 versus 68±14 beats.min–1, P<0·01 and minimal 24-h heart rate (32±6 versus 42±11 beats.min–1, P<0·01 Cardiac pauses >2·5 s were present in 13 patients during control recording; after theophylline they disappeared in 11 and markedly decreased in the remaining two. The longest R-R interval decreased in all patients (3218±943 versus 2121±518ms, P<0·01). The daily number of wide QRS complexes increased in 16 out of 17 patients (428±752 versus 1146±1464 ms, P<0·01). Exercise heart rate, evaluated at the end offirsi andsecondstage, was higher after theophylline than during control test (P<0·01).

These data suggest that oral theophylline can represent a valid therapy in most patients with atrialfibrillation and a slow ventricular response.

Key Words: Theophylline • atrial fibrillation • atrio-ventricular conduction disturbances


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