Effect of combined use of intravenous salbutamol and aminophylline on cardiac rhythm in chronic obstructive lung disease.

The effect on cardiac rhythm of intravenous administration of salbutamol during prolonged aminophylline infusion was evaluated by means of ECG Holter monitoring in 20 patients with chronic obstructive lung disease (COLD) without respiratory failure. Data were compared with a baseline 24-hour Holter monitoring during which an individual arrhythmia pattern was established for each patient. Intravenous administration of aminophylline with fast achievement of therapeutic plasma levels, has a variable and nonsignificant influence on supraventricular arrhythmias, whilst a statistically significant increase of premature ventricular contractions (PVCs) has been observed. However, such an increase concerns only isolated PVCs, is conditioned by the pattern of preexisting arrhythmias and is independent of plasma aminophylline level. Acute intravenous administration of salbutamol during infusion of aminophylline is not associated with a higher incidence of major arrhythmias. So we conclude that such a pharmacological combination does not represent an additional risk of serious cardiac rhythm disturbances in a selected population of COLD patients without further known arrhythmogenic risk factors. Moreover, plasma aminophylline levels are not predictive of a possible higher incidence of ventricular arrhythmias.