Exploring the Role of Isoproterenol in Atrioventricular Blocks Management: A Literature Review
Keywords:
isoproterenol, isoprenaline, atrioventricular block, atrioventricular blocks, AV blocksAbstract
Atrioventricular (AV) block is a condition characterised by impaired conduction of impulses between atria and ventricles with varying degrees of severity. Isoproterenol, a non-selective beta-adrenergic agonist, is used in the treatment of AV blocks, especially in cases of Mobitz type 2 and complete heart blocks. Its mechanism in patients with AV blocks is increasing A-V nodal conduction. Isoproterenol has shown efficacy in the management of hemodynamically unstable patients with Mobitz type 2 and third-degree AV block while waiting for permanent pacemaker placement. It has been approved for heart blocks where a pacemaker is not needed and for cardiac arrest caused by heart block where pacemaker treatment is not an option. It has many potential side effects such as increased heart rate, hypotension, and myocardial ischemia, therefore, careful monitoring is necessary. Summarizing it, isoproterenol has a vital role in treating AV blocks and offers an alternative drug in both acute management and long-term treatment options. However, future research is needed to compare the safety and efficacy of isoproterenol which could help make the best treatment strategies in patients with AV blocks.
Downloads
References
Gomes JAC, El-Sherif N. Atrioventricular block. Mechanism, clinical
presentation, and therapy. Med Clin North Am [Internet]. 1984;68(4):955–67.
Available from: http://dx.doi.org/10. HYPERLINK
"http://dx.doi.org/10.1016/S0025-7125(16)31108-7" HYPERLINK
"http://dx.doi.org/10.1016/S0025-7125(16)31108-7" HYPERLINK
"http://dx.doi.org/10.1016/S0025-7125(16)31108-7"1016/S0025-
(16)31108-7
Serge Barold S, Hayes DL. Second-degree atrioventricular block: A
reappraisal. Mayo Clin Proc. 2001;76(1):44–57.
Saleh F, Greene EA, Mathison D. Evaluation and management of
atrioventricular block in children. Curr Opin Pediatr. 2014;26(3):279–85.
Vargas G, Akhtar M, Damato AN. Electrophysiologic effects of isoproterenol on
cardiac conduction system in man. Am Heart J. 1975;90(1):25–34.
Gump A, Haughney L, Fredberg J. Relaxation of activated airway smooth
muscle: Relative potency of isoproterenol vs. tidal stretch. J Appl Physiol.
;90(6):2306–10.
YEAGER H, WEINBERG RM, KAUFMAN L V., KATZ S. Asthma: Comparative
Bronchodilator Effects of Ipratropium Bromide and Isoproterenol. J Clin
Pharmacol. 1976;16(4):198–204.
Valentine. Asthmatic Patients. Anesthesiology. 1971;34(5):420–420.
Ota M. NII-Electronic Library Service. Chem Pharm Bull [Internet].
;(43):2091. Available from: http://www.mendeley.com/research/geology volcanic-history-eruptive-style-yakedake-volcano-group- HYPERLINK
Tantaka H, Clark RB, Giles WR. Positive chronotropic responses of rabbit
sino-atrial node cells to flash photolysis of caged isoproterenol and cyclic AMP.
Proc R Soc B Biol Sci. 1996;263(1368):241–8.
Bull M, Shelke, A. R. , Roscoe, J. A. , Morrow, G. R. , Colman, L. K. ,
Banerjee, T. K. , & Kirshner JJ. 基因的改变 NIH Public Access. Bone [Internet].
;23(1):1–7. Available from: https://www.ncbi.n HYPERLINK
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688697/pdf/nihms-
pdf" HYPERLINK
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688697/pdf/nihms-
pdf" HYPERLINK
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688697/pdf/nihms-
pdf"lm.nih.gov/pmc/articles/PMC2688697/pdf/nihms-110443.pdf
二十七、 Rooks, M.G and Garrett, W.S 2016. 乳鼠心肌提取 HHS Public
Access. Physiol Behav. 2017;176(3):139–48.
Dhingra RC, Winslow E, Pouget JM, Rahimtoola SH, Rosen KM. The effect of
isoproterenol on atrioventricular and intraventricular conduction. Am J Cardiol.
;32(5):629–36.
De Lazzari M, Martini N, Migliore F, Donato F, Babuin L, Tarantini G, et al.
Efficacy and Safety of Isoprenaline during Unstable Third-Degree
Atrioventricular Block. J Cardiovasc Dev Dis. 2023;10(12):1–10.
Chihrin SM, Mohamed U, Yee R, Gula LJ, Klein GJ, Skanes AC, et al. Utility of
Isoproterenol in Unmasking Latent Escape Rhythm in Pacemaker Dependent
Patients Undergoing Pacemaker Replacement. Am J Cardiol.
;101(5):631–3.
Patel PJ, Segar R, Patel JK, Padanilam BJ, Prystowsky EN. Arrhythmia
induction using isoproterenol or epinephrine during electrophysiology study for
supraventricular tachycardia. J Cardiovasc Electrophysiol. 2018;29(12):1635–
Ehlers TS, van der Horst J, Møller S, Piil PK, Gliemann L, Aalkjær C, et al.
Colchicine enhances β adrenoceptor-mediated vasodilation in men with
essential hypertension. Br J Clin Pharmacol. 2023;89(7):2179–89.
Oberoi GS, Saini SS. Induced hypotension in a smoker. P N G Med J. 1994;37(4):224–5.
Hatle L, Rokseth R. Conservative treatment of AV block in acute myocardial
infarction. Results in 105 consecutive patients. Br Heart J. 1971;33(4):595–600.
Zappa D, Herman LL. ORAL bo ds ORAL bo ds. 2022;1–29.
Headrick JP, Gauthier NS, Morrison RR, Matherne GP. Chronotropic and
vasodilatory responses to adenosine and isoproterenol in mouse heart: Effects
of adenosine A1 receptor overexpression. Clin Exp Pharmacol Physiol.
;27(3):185–90.
Su LN, Wu MY, Cui YX, Lee CY, Song JX, Chen H. Unusual course of
congenital complete heart block in an adult: A case report. World J Clin Cases.
;10(19):6602–8.
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold
MR, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management
of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the
American College of Cardiology/American Heart Association Task Force on
Clinical Practice Guidelines and the Heart Rhythm Society. Vol. 140,
Circulation. 2019. 382–482 p.
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
