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Brain & Heart Atropine can reducing reperfusion vagal reflex in STEMI

rate of <60 beats/min (bpm) ; and ventricular tachycardia
[8]
was defined as a series of more than three consecutive
premature ventricular complexes at a rate faster than
100 bpm .
[9]
2.5. Statistical analysis
The Kolmogorov–Smirnov test was used to test the
normality of the distribution. Continuous variables
were presented as means and standard deviations, and
unpaired t-tests and Mann–Whitney tests were used
for comparisons between the two groups. Categorical
variables were presented as frequencies and percentages
and were compared using Chi-squared test. P < 0.05 was
considered statistically significant for all analyses, which
were performed using SPSS 26.0.
3. Results

3.1. Characteristics of the study participants
A flow chart showing the selection and enrollment of Figure 1. Study protocol.
patients is presented in Figure 1. Of the 378 patients STEMI: ST-elevation myocardial infarction; NSTEMI: Non-ST-elevation
initially selected, 142 patients were eligible to participate myocardial infarction.
in this study. Of these patients, 70 received atropine
preconditioning (40, low-dose atropine; 30, high-dose of frequent premature ventricular contraction, and seven
atropine), while 72 did not. cases of ventricular tachycardia or ventricular fibrillation.
The characteristics of the study participants at the time There was no significant difference in the incidence of
of enrollment are shown in Tables 1 and 2. No significant secondary tachyarrhythmia between the experimental
differences were found with regard to age, sex, body mass group and the control group (25.7% vs. 34.7%, P > 0.05).
index (BMI), smoking history, hypertension, diabetes The occurrence of secondary arrhythmia and extracardiac
mellitus, stroke, left ventricular ejection fraction (LVEF), symptoms during and after PCI in the control group and
single branch lesion, right coronary atherosclerosis, chest the experimental group is summarized in Table 4.
pain, or door-to-balloon time between the experimental In the subgroup analysis, the inhibition of reperfusion
group and the control group (all P > 0.05) (Table 1) or vagal reflex-related events by different doses of atropine
between the low-dose group and the high-dose group (all indicated that patients who received high-dose (2 mg)
P > 0.05) (Table 2). atropine had a lower risk of bradycardia (10% vs. 35%),
In the experimental (n = 70) and control groups hypotension (6.70% vs. 27.50%), ventricular tachycardia
(n = 72), bradycardia occurred in 24.3% (17/70) and 45.8% (6.70% vs. 25%), and ventricular fibrillation (0% vs. 15%)
(33/72) of patients, respectively; hypotension occurred in than those who received low-dose (0.5–1mg) atropine;
18.6% (13/70) and 40.3% (29/72) of patients, respectively; moreover, the incidence of temporary pacemaker
ventricular tachycardia occurred in 4.3% (3/70) and 19.40% implantation was also lower in the former group of patients
(14/72) of patients, respectively; ventricular fibrillation (3.30% vs. 22.50%) (all P < 0.05) (Table 5). However,
occurred in 8.6% (6/70) and 20.8% (15/72) of patients, the incidence (46.7% vs. 10.0%, P < 0.05) of secondary
respectively; and temporary pacemaker was inserted in tachyarrhythmias (sinus tachycardia) with heart rate over
14.3% (10/70) and 29.2% (21/72) of patients, respectively. 130 bpm was higher in the high-dose group.
There was no death in either group. The incidence of
reperfusion vagal reflex-related events was significantly 4. Discussion
lower in the experimental group (all P < 0.05) (Table 3). The majority of inferior STEMI cases are caused by
In the experimental group, there were 17 cases of sinus right coronary occlusion, with a small proportion being
tachycardia with heart rate over 130 bpm and a case of rapid attributed to left circumflex artery occlusion. Both the right
atrial fibrillation. In the control group, there were 15 cases of coronary artery and the left circumflex artery supply blood
sinus tachycardia with heart rate over 130 bpm, three cases to the sinoatrial node, atrioventricular node, and atrium.

Volume 1 Issue 1 (2023) 3 https://doi.org/10.36922/bh.193