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Interventions for Bradycardia

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Current pharmacological management of bradycardia in SCI patients involves the use of different agents including phosphodiesterase inhibitors (e.g., aminophylline, theophylline), vasopressors, and chronotropic agents (e.g., atropine, epinephrine, norepinephrine) (Biering-Sørensen et al., 2018). Cardiac pacemaker implantation as therapy for bradycardia is only reserved for those patients with refractory bradycardia who do not respond to pharmacologic treatment (Evans et al., 2014; Franga et al., 2006; Ruiz-Arango et al., 2006; Sadaka et al., 2010; Wood et al., 2014). Treatment may warrant both alpha and beta-adrenergic actions as there is a loss of sympathetic tone and at the same time a need for chronotropic support (Biering-Sørensen et al., 2018).