What is the clinical evidence from this study?

Study design: Observational. Population: Paroxysmal supraventricular tachycardia (n=8). Intervention: Verapamil vs. Pretreatment baseline. Primary outcome: AH interval at 15 minutes (p=<0.01).

January 1, 1983Open Access

Pharmacokinetics and electrophysiological effects of verapamil in patients with paroxysmal supraventricular tachycardia.

Q: What are the key findings of this study?

Intravenous administration of 10 mg verapamil significantly prolonged the AH interval from 99 to 150 msec and increased the effective and functional refractory periods of the AV node.

Key Result

Intravenous administration of 10 mg verapamil significantly prolonged the AH interval from 99 to 150 msec and increased the effective and functional refractory periods of the AV node.

Study Design

Type

Observational (n=8)

Multicenter

Structured PICO

Does intravenous verapamil alter electrophysiological properties in a concentration-dependent manner in patients with paroxysmal supraventricular tachycardia?

Population

8 adult patients (mean age 57.1 years, 50% female) with a history of recurrent paroxysmal supraventricular tachycardia, evaluated for pharmacokinetics and electrophysiological effects after verapamil administration.

Intervention

Verapamil 10 mg administered intravenously, with injection completed within a two-minute time period.

Comparator

Pretreatment control period (baseline measurements prior to drug administration).

Outcome

Pharmacokinetic parameters (biological half-life, apparent volume of distribution, total body clearance) and electrophysiological effects (AH interval, HV interval, ERPAVN, FRPAVN, antegrade echo zone, and supraventricular tachycardia zone).surrogate

Intravenous verapamil prolongs AV nodal conduction and refractoriness in a concentration-dependent manner, providing a pharmacokinetic and electrophysiological basis for its efficacy in terminating paroxysmal supraventricular tachycardia.

Main Result

Absolute Event Rate: 150% vs 99%

p-value: p=<0.01

Limitations

Small sample size of 8 patients
Control values for ERPAVN were obtained in only two patients

Abstract

Ten mg of verapamil was administered intravenously to eight patients with paroxysmal supraventricular tachycardia. After drug administration, investigation of the pharmacokinetics of verapamil was carried out, and the relationship between plasma verapamil concentration and its electrophysiological effects was studied. After verapamil administration, pharmacokinetic parameters were calculated using a two-compartment open model. Biological half-life ranged from 2.91 to 4.55 hours and apparent volume of distribution ranged from 1.28 to 3.18 L/kg. Total body clearance ranged from 216 to 733 ml/min.Verapamil significantly prolonged the AH interval but did not prolong the HV interval. The effective and the functional refractory period of the AV node (ERPAVN and FRPAVN) were also prolonged after verapamil administration. The antegrade echo zone and the supraventricular tachycardia zone were also narrowed in most patients. A concentration-dependent relationship between plasma verapamil andpercent increase of both ERPAVN and AH interval was observed.

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Cite This Study

Koike et al. (Sat,) conducted a observational in Paroxysmal supraventricular tachycardia (n=8). Verapamil vs. Pretreatment baseline was evaluated on AH interval at 15 minutes (p=<0.01). Intravenous administration of 10 mg verapamil significantly prolonged the AH interval from 99 to 150 msec and increased the effective and functional refractory periods of the AV node.

synapsesocial.com/papers/6a22f292816bec650460d662 https://doi.org/https://doi.org/10.3999/jscpt.14.495

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