The use of small-dose theophylline for the treatment of bradycardia in patients with spinal cord injury.

Small-dose theophylline can be a useful alternative in the treatment of bradycardia in patients with spinal cord injury. In this series of three cases, I describe its successful use for this indication. In one case, initiation of theophylline treatment also increased respiratory drive and minute ventilation. A possible mechanism is that theophylline increases the force of contraction of diaphragmatic muscles because of enhancement of calcium uptake through an adenosine-mediated channel. The antibradycardiac effect is probably mediated through one or more different molecular mechanisms, which seem to be mediated by inhibition of phosphodiesterase 3.