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September 1, 1975The Medical Journal of Australia

Clinical Experience With Verapamil

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Why the study?

Does intravenous verapamil restore sinus rhythm in supraventricular tachycardia and reduce ventricular rate in atrial fibrillation?

Population

Patients with episodes of supraventricular tachycardia, atrial fibrillation, and cases undergoing…

Design

Case_series

Authors

JVJitu VohraThe Royal Melbourne HospitalDHDavid HuntBond UniversityGSGraeme SlomanThe Royal Melbourne Hospital

Discussion

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Implication

Hypothesis-generating for IV verapamil in SVT termination; prospective trials needed before clinical adoption.

Key Points

  • To evaluate the clinical efficacy and electrophysiological effects of intravenous verapamil in the management of supraventricular tachycardia and atrial fibrillation.
  • Administered intravenous verapamil to patients during episodes of supraventricular tachycardia and atrial fibrillation.
  • Performed intracardiac conduction studies utilizing His bundle electrograms before and after a 5 mg intravenous dose of verapamil (n=9).
  • Intravenous verapamil restored normal sinus rhythm in 33 of 40 episodes of supraventricular tachycardia and slowed the ventricular response rate in atrial fibrillation.
  • Atrioventricular nodal conduction time was prolonged in 8 of 9 patients without altering distal conduction pathways, while adverse bradycardia and hypotension occurred in 2 patients and resolved following atropine administration.

Structured PICO

Does intravenous verapamil restore sinus rhythm in supraventricular tachycardia and reduce ventricular rate in atrial fibrillation?

P
Population
Patients with episodes of supraventricular tachycardia (40 episodes), atrial fibrillation, and cases undergoing intracardiac conduction studies (n=9)
I
Intervention
Intravenous verapamil (including 5 mg dose for conduction studies)
O
Outcome
Restoration of sinus rhythm, reduction of ventricular rate, and changes in intracardiac conduction

Intravenous verapamil is an effective and generally safe antiarrhythmic agent for terminating supraventricular tachycardia and controlling ventricular rate in atrial fibrillation.

Cite This Study

Vohra et al. (1975) studied this question.

synapsesocial.com/papers/6a7472c70081fe7b05dbd425https://doi.org/10.5694/j.1326-5377.1975.tb105937.x

Topics

Atrial fibrillationPersistent AF management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Immediate effects of intravenous verapamil on atrial fibrillation1971 · 124 citations
  2. 2A fourth class of anti-dysrhythmic action? Effect of verapamil on ouabain toxicity, on atrial and ventricular intracellular potentials, and on other features of cardiac function1972 · 291 citations
  3. 3Effect of verapamil on contractility, oxygen utilization, and calcium exchangeability in mammalian heart muscle1972 · 209 citations
  4. 4Lown-Ganong-Levine Syndrome1971 · 50 citations
  5. 5Action of verapamil on sinus node, atrioventricular, and intraventricular conduction.1973 · 117 citations