Theophylline shows promise in SCI-induced bradycardia

Use of theophylline as an adjunctive therapy appears to lead to favourable outcomes among patients with bradycardia due to acute spinal cord injury (SCI) with an acceptable response to this agent, suggest the results of a study.

“SCI-related bradycardia occurs frequently in patients with high cervical spine injuries,” the investigators said. “In patients with SCI-related symptomatic bradycardia, a variety of agents have been used to improve heart rate and reduce the need for vasopressor therapy.”

To examine and describe the use of theophylline for SCI-related symptomatic bradycardia, a retrospective case series was conducted on patients with bradycardia who have been treated with the study drug.

The investigators assessed the participants based on the clinical response to theophylline. They then classified the patients as a responder if vasopressors were discontinued or the number of bradycardia episodes decreased following the treatment with theophylline.

Twenty-six patients met the eligibility criteria, of which 17 (65.4 percent) were classified as responders, five (19.2 percent) nonresponders, and four (15.4 percent) undetermined. Eleven patients (43.31 percent) were discharged on theophylline, of whom seven (41.2 percent) were classified as responders.

Notably, no significant differences were observed between patients classified as responders and those who were not.

“This case series suggests that theophylline could be used as adjunctive therapy in patients with bradycardia secondary to acute SCI who achieve an adequate response to theophylline,” the investigators said.