Aminophylline in the treatment of atropine-resistant bradyasystole

Aminophylline is a non-specific adenosine receptor antagonist that may have a clinical use in the treatment of patients with certain types of bradyasystole. The pathogenesis of ischemia-related bradyasystole, with respect to the role of endogenous adenosine, provides a compelling rationale for potential beneficial effects of aminophylline in certain types of bradyasystolic conditions but the evidence is primarily anecdotal and to date, clinical trials have been inconclusive. We present a comprehensive literature review of aminophylline use in human subjects with bradyasystole and provide recommendations for clinical use and future study.