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Brain & Heart

ORIGINAL RESEARCH ARTICLE
Potential use of prophylactic intracoronary

atropine in reducing reperfusion vagal
reflex-related events in ST-elevation myocardial

infarction

1†
2†
Junlong Hou , Erqing Li , Yichao Duan , Jing Wang , Bin Chen ,
1
1
1
1
Chuanmin Fan , Liming Qin , Bo Zhang , and Lingping Xu *
1
1
1
1 Department of Cardiovascular Medicine, Xianyang Central Hospital, Xianyang, China
2 Interventional Lab, Xianyang Central Hospital, Xianyang, China
Abstract
In this study, we evaluated the potential use of atropine in reducing reperfusion
vagal reflex-related events during emergency percutaneous coronary intervention
(PCI) for acute inferior ST-elevation myocardial infarction (STEMI). Retrospectively,
we included 142 patients with inferior wall STEMI, who were treated between
October 2015 and October 2020, in this study. The patients were divided into an
experimental group (n = 70) and a control group (n = 72) depending on whether
they received prophylactic intracoronary atropine. The experimental group was
then subdivided into a low-dose group (0.5 – 1 mg atropine, n = 40) and a high-
† These authors contributed equally
to this work. dose group (2 mg atropine, n = 30). We compared the incidence of reperfusion vagal
reflex-related events and the application of temporary pacemakers between these
*Corresponding author:
Lingping Xu groups. The results showed that the incidence of bradycardia (24.3% vs. 45.8%,
(1002120803@qq.com) P = 0.007), hypotension (18.6% vs. 40.3%, P = 0.005), ventricular tachycardia (4.3%
vs. 19.4%, P = 0.005), and ventricular fibrillation (8.6% vs. 20.8%, P = 0.040) as well
Citation: Hou J, Li E, Duan Y, et al.,
2023, Potential use of prophylactic as the application of temporary pacemakers (14.3% vs. 29.2%, P = 0.032) were all
intracoronary atropine in reducing much lower (all P < 0.05) in the experimental group than in the control group. In
reperfusion vagal reflex-related addition, the incidence of bradycardia (10% vs. 35%, P = 0.016), hypotension (6.7%
events in ST-elevation myocardial
infarction. Brain & Heart, 1(1): 193. vs. 27.5%, P = 0.027), ventricular tachycardia (6.7% vs. 25%, P = 0.044), and ventricular
https://doi.org/10.36922/bh.193 fibrillation (0 vs. 15%, P = 0.034) as well as the application of temporary pacemakers
Received: September 13, 2022 (3.3% vs. 22.5%, P = 0.036) were all much lower (all P < 0.05) in the high-dose group
than the low-dose group. Our findings demonstrate that atropine pretreatment
Accepted: January 12, 2023 could prevent reperfusion vagal reflex-related events and reduce the application of
Published Online: March 15, 2023 temporary pacemakers during emergency PCI for acute inferior STEMI. These effects
Copyright: © 2023 Author(s). can be significantly enhanced by high-dose (2 mg) atropine pretreatment.
This is an Open Access article
distributed under the terms of the
Creative Commons Attribution Keywords: ST-elevation myocardial infarction; Acute inferior myocardial infarction;
License, permitting distribution, Emergency percutaneous coronary intervention; Atropine; Vagal reflex; Reperfusion reaction
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Reperfusion vagal reflex-related events, such as bradycardia and hypotension, often
affiliations. occur in acute myocardial infarction, especially in the early stage of inferior or posterior

Volume 1 Issue 1 (2023) 1 https://doi.org/10.36922/bh.193