Why the study?
Does intravenous verapamil reduce ventricular rate or improve conversion to sinus rhythm in patients with rapid ventricular rate and atrial fibrillation or atrial flutter?
Does intravenous verapamil reduce ventricular rate or improve conversion to sinus rhythm in patients with rapid ventricular rate and atrial fibrillation or atrial flutter?
Intravenous verapamil is highly effective at rapidly slowing the ventricular rate in patients with atrial fibrillation or flutter compared to saline.
Supports IV verapamil for acute rate control in AF; confirms superiority over saline in this RCT.
A double-blind randomized study was performed to compare the efficacy of intravenous verapamil with saline in 28 patients with a rapid ventricular rate and atrial fibrillation or atrial flutter. Conversion of atrial fibrillation to sinus rhythm occurred in none of 14 patients after saline and in 3 of 20 patients (15%) 7 to 160 min after verapamil. The ventricular rate in atrial fibrillation was slowed greater than or equal to 15% in 2 of 14 patients (14%) by saline, in 17 of 20 patients (85%) by 1 dose of verapamil (p less than 0.001), and in 19 of 20 patients (95%) by 1 or 2 doses of verapamil (p less than 0.001). Conversion of atrial flutter to sinus rhythm occurred in none of 4 patients after saline and in 1 of 7 patients (14%) 105 min after verapamil. The ventricular rate in atrial flutter was slowed greater than or equal to 15% in none of 4 patients by saline, in 4 of 7 patients (57%) by 1 dose of verapamil, and in 7 of 7 patients (100%) by 1 or 2 doses of verapamil (p less than 0.001).
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Aronow et al. (1979) studied this question.
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