ABSTRACT
During COVID-19 pandemic, one of the most common arrythmia reported with this illness is sinus bradycardia. Treatment for COVID-19 and associated cardiac dysfunction is still evolving. Temporary pacemaker insertion is difficult due to pandemic and risk of spread of infection to the additional staff involved. Orciprenaline stimulates the sino-atrial and atrioventricular nodes and accelerates atrioventricular conduction. Theophylline improves sinus node function in subjects with sinus bradycardia and enhances atrioventricular nodal conduction We report a case series of 10 patients admitted in dedicated COVID-19 ICUs and developed sinus node dysfunction. All of these patients were started on etophylline and theophylline prolonged release tablet (150mg) once a day. On subsequent follow up after 72 hours, all patients reported heart rate well within normal range. COVID-19 virus directly involves the myocardium by entering the cardiac myocytes resulting in inflammation and injury. As the sinus bradycardia due to COVID-19 is usually transient and respond well this drug, short course of this drug could be added to treat this arrythmia in future.
ABSTRACT
Background: The present study evaluated the changes in baseline left ventricular function and clinical symptoms in multi-vessel coronary artery disease patients after multi-vessel percutaneous coronary intervention.Methods: This was a prospective, observational study conducted at Medical Super-speciality Hospital, Kolkata, India, between August 2017 and August 2019. The study included 48 patients who were diagnosed with ≥2 coronary artery stenosis of ≥50% in native coronary arteries with left ventricular ejection fraction (LVEF) <40%. Echocardiography was performed before and after 3 months of the procedure to observe LVEF. Canadian Cardiovascular Society (CCS) score was calculated before and after 3 months after PCI.Results: Mean age of the patients was 61.89±9.96 years and 89.6% patients were male. Mean LVEF before and after angioplasty was 34.9±4.95% and 42.06±8.78%, respectively (p=0.001). CCS score before and after angioplasty was 2.89 and 1.83, respectively (p=0.001).Conclusions: The results displayed significant improvement in clinical symptoms as well as LVEF after PCI in patients with multi-vessel disease with LVEF <40%. These results will be helpful to conduct larger randomized trials with long term follow-up in order to prove the safety and effectiveness of PCI in such patients over coronary artery bypass grafting.