A mix of aminophylline and heparin plus nitroglycerin can reduce bradycardia during rotational atherectomy on the right coronary artery and dominant circumflex artery

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dc.authorid0000-0001-6595-7493en_US
dc.authorid0000-0002-4021-3444en_US
dc.authorid0000-0002-6913-9073en_US
dc.authorid0000-0002-6724-1445en_US
dc.contributor.authorAcar, Emrah
dc.contributor.authorİzci, Servet
dc.contributor.authorDönmez, İbrahim
dc.contributor.authorÖzgül, Neryan
dc.contributor.authorÖzcan, Eda
dc.contributor.authorKaygusuz, Tuba
dc.date.accessioned2024-02-16T13:51:41Z
dc.date.available2024-02-16T13:51:41Z
dc.date.issued2023en_US
dc.departmentBAİBÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackgroundRotational 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 and methodsThe study comprised 60 patients who were randomly divided into two groups: 30 received rotaphylline (= 240 mg aminophylline, 10,000 U unfractionated heparin, and 2000 mcg nitroglycerin to 1000 mL saline), and 30 received the traditional rota-flush (= 10,000 U unfractionated heparin, 2000 mcg nitroglycerin, and 1000 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.ResultsThe 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, p < 0.001). Lesion length (OR: 2.17, 95% CI: 1.24-3.04, p < 0.001), burr-to-artery ratio (OR: 0.59, 95% CI: 0.39-1.68, p < 0.001), and total run duration (OR: 0.79, 95% CI: 0.35-1.43, p < 0.001) were additional independent predictors.ConclusionBradycardia 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.en_US
dc.identifier.citationAcar, E., Izci, S., Donmez, I., Ozgul, N., Ozcan, E., Kaygusuz, T., ... & Kirma, C. (2023). 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.en_US
dc.identifier.doi10.1007/s00059-023-05195-1
dc.identifier.endpage486en_US
dc.identifier.issn0340-9937
dc.identifier.issn1615-6692
dc.identifier.issue48en_US
dc.identifier.pmid37401989en_US
dc.identifier.scopus2-s2.0-85163839200en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage480en_US
dc.identifier.urihttp://dx.doi.org/10.1007/s00059-023-05195-1
dc.identifier.urihttps://hdl.handle.net/20.500.12491/12032
dc.identifier.wosWOS:001023678300001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorAcar, Emrah
dc.institutionauthorDönmez, İbrahim
dc.language.isoenen_US
dc.publisherUrban & Vogelen_US
dc.relation.ispartofHerzen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAminophyllineen_US
dc.subjectAtherectomyen_US
dc.subjectAtrioventricular Blocken_US
dc.subjectRota-Flush Solutionen_US
dc.subjectAtrioventricular-Conductionen_US
dc.subjectGuinea-Pigen_US
dc.titleA mix of aminophylline and heparin plus nitroglycerin can reduce bradycardia during rotational atherectomy on the right coronary artery and dominant circumflex arteryen_US
dc.typeArticleen_US

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