PMID: 3760393Nov 1, 1986Paper

Mechanism of atropine-resistant atrioventricular block during inferior myocardial infarction: possible role of adenosine

Journal of the American College of Cardiology
R C WesleyL Belardinelli

Abstract

Mechanisms responsible for atrioventricular (AV) block during acute inferior myocardial infarction are only partially understood. Increased parasympathetic tone is the factor usually postulated; however, persistence of AV block after atropine administration is frequently observed. Adenosine, an endogenous ischemic metabolite, has well established depressant effects on AV node conduction. In this report, an episode of atropine-resistant AV block was reversed by aminophylline, a competitive adenosine antagonist, in a patient with an acute inferior myocardial infarction. This observation suggests a role for adenosine in the mediation of ischemia-induced AV node block.

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