Successful Reversal of Bradycardia and Dyspnea With Aminophylline After Ticagrelor Load
2018
A 69-year-old male underwent elective
percutaneous coronary interventionrequiring placement of a
drug-eluting stentto the first
obtuse marginal artery. Four hours following the administration of a
ticagrelor
loading dose, he developed dyspnea and sinus pauses.
Aminophyllinewas administered and resulted in immediate and sustained symptom resolution.
Ticagrelorhas been associated with dyspnea and bradyarrhythmias, both attributed to increased
adenosineexposure.
Ticagrelorinhibits
reuptakeof intracellular
adenosine.
Adenosineantagonists
aminophyllineand
theophyllinehave been utilized to reverse the effects of
adenosineand may relieve
adenosine-mediated adverse effects induced by
ticagrelortherapy.
Aminophyllinemay be considered for reversal of dyspnea and bradyarrhythmia associated with
ticagrelortherapy through alterations in
adenosineexposure.
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