December 1, 1980Annals of Internal Medicine
Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders. Part I: Basic and Clinical Electrophysiologic Effects
Why the study?
Are calcium channel blocking agents effective in the treatment of cardiovascular disorders and supraventricular arrhythmias?
Population
Patients with cardiovascular disorders, specifically supraventricular arrhythmias
Design
Review
Authors
Discussion
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Implication
Supports verapamil for re-entrant SVTs including PSVT, AF, and flutter; leaves open need for randomized confirmation.
Key Points
- Summarize the cellular electrophysiologic mechanisms of calcium channel blocking drugs and assess their therapeutic efficacy across clinical cardiovascular disorders.
- Synthesized mechanistic data on calcium ion inhibition during the slow inward current phase of cellular depolarization.
- Reviewed electrophysiologic and clinical trial data evaluating four primary calcium antagonists: verapamil, nifedipine, perhexiline, and diltiazem.
- Verapamil exerts pronounced inhibitory effects on slow inward currents, distinguishing it as a potent antiarrhythmic agent relative to other calcium blockers.
- Intravenous verapamil effectively terminates acute re-entrant supraventricular arrhythmias, with substantial efficacy in paroxysmal supraventricular tachycardia.
- Preliminary trials indicate oral verapamil successfully controls ventricular rate and maintains sinus rhythm during long-term treatment of atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia.
Structured PICO
Are calcium channel blocking agents effective in the treatment of cardiovascular disorders and supraventricular arrhythmias?
P
Population
Patients with cardiovascular disorders, specifically supraventricular arrhythmias (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter)
I
Intervention
Calcium channel blocking agents (verapamil, nifedipine, perhexiline, diltiazem)
O
Outcome
Control of supraventricular arrhythmias
This review highlights the emerging role of calcium channel blockers, particularly verapamil, as valuable antiarrhythmic agents for managing supraventricular tachycardias.
Cite This Study
Elliott M. Antman (1980) studied this question.