Background: Patients affected by syncope without or with very short (≤5 s)prodrome with normal heart and normal ECG have been seen to present low plasma adenosine levels. We investigated whether chronic treatment of these patients with theophylline, a non-selective adenosine receptor antagonist, results in clinical benefit. Methods: In a consecutive case-series of 16 patients (mean age 47 ± 25 years, 9 females)who had ECG documentation of asystolic syncope, we compared the incidence of syncopal recurrence during a period without and a period with tailored theophylline therapy. Results: During a median of 60 months before ECG documentation of the index episode, the patients had a median of 2 syncopes per year. During the 6 months of the study phase without therapy, the patients had a median of 2.6 syncopes per year, p = 0.63. During the 23 months of the study phase with theophylline, the patients had a median of 0.4 syncopes per year, p = 0.005 vs history and p = 0.005 vs no therapy. In the 13 patients who had an implantable loop recorder during both study phases, the incidence of asystolic episodes > 3 s decreased from 9.6 per year to 1.1 per year, p = 0.0007. During theophylline treatment, syncope recurred in 1/5 (20%)patients who had an idiopathic atrioventricular block as the index event versus 9/11 (81%)patients who had a sinus arrest, p = 0.005. Conclusion: Theophylline is effective in reducing syncopal burden in patients with syncope without prodromes with normal heart and normal ECG. Its efficacy is greater in those with idiopathic atrioventricular block.

Efficacy of theophylline in patients with syncope without prodromes with normal heart and normal ECG / Brignole M.; Iori M.; Solari D.; Bottoni N.; Rivasi G.; Ungar A.; Deharo J.C.; Guieu R.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - STAMPA. - 289:(2019), pp. 70-73. [10.1016/j.ijcard.2019.03.043]

Efficacy of theophylline in patients with syncope without prodromes with normal heart and normal ECG

Rivasi G.;Ungar A.;
2019

Abstract

Background: Patients affected by syncope without or with very short (≤5 s)prodrome with normal heart and normal ECG have been seen to present low plasma adenosine levels. We investigated whether chronic treatment of these patients with theophylline, a non-selective adenosine receptor antagonist, results in clinical benefit. Methods: In a consecutive case-series of 16 patients (mean age 47 ± 25 years, 9 females)who had ECG documentation of asystolic syncope, we compared the incidence of syncopal recurrence during a period without and a period with tailored theophylline therapy. Results: During a median of 60 months before ECG documentation of the index episode, the patients had a median of 2 syncopes per year. During the 6 months of the study phase without therapy, the patients had a median of 2.6 syncopes per year, p = 0.63. During the 23 months of the study phase with theophylline, the patients had a median of 0.4 syncopes per year, p = 0.005 vs history and p = 0.005 vs no therapy. In the 13 patients who had an implantable loop recorder during both study phases, the incidence of asystolic episodes > 3 s decreased from 9.6 per year to 1.1 per year, p = 0.0007. During theophylline treatment, syncope recurred in 1/5 (20%)patients who had an idiopathic atrioventricular block as the index event versus 9/11 (81%)patients who had a sinus arrest, p = 0.005. Conclusion: Theophylline is effective in reducing syncopal burden in patients with syncope without prodromes with normal heart and normal ECG. Its efficacy is greater in those with idiopathic atrioventricular block.
2019
289
70
73
Goal 3: Good health and well-being for people
Brignole M.; Iori M.; Solari D.; Bottoni N.; Rivasi G.; Ungar A.; Deharo J.C.; Guieu R.
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1190074
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