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May 1, 1974Postgraduate Medical JournalOpen Access

The effect of Verapamil on the cardiac conduction system in man

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Why the study?

Does Verapamil affect the cardiac conduction system in patients undergoing routine cardiac catheterization?

Population

11 patients undergoing routine cardiac catheterization

Design

Case_series

Authors

PRP. RoyConcord Repatriation General HospitalRSR A SpurrellGuy's HospitalESE SowtonGuy's Hospital

Discussion

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Implication

Alerts to potential direct AV nodal effects during catheterization; leaves open clinical relevance pending controlled studies.

Key Points

  • To evaluate the electrophysiological effects of verapamil on the specialized cardiac conduction system and refractory periods in humans.
  • Conducted His bundle electrography in 11 patients during routine cardiac catheterization.
  • Measured absolute and relative refractory periods and retrograde A-V nodal conduction in 5 patients using programmed electrical stimulation, testing reversibility with atropine.
  • Verapamil prolonged both anterograde and retrograde A-V nodal conduction times while exerting no significant effect on the remainder of the cardiac conduction system.
  • The prolongation of anterograde conduction was only partially reversed by atropine, demonstrating a direct nodal action independent of vagotonic mechanisms.

Structured PICO

Does Verapamil affect the cardiac conduction system in patients undergoing routine cardiac catheterization?

P
Population
11 patients undergoing routine cardiac catheterization
I
Intervention
Verapamil
O
Outcome
Effect on the specialized conduction system (anterograde and retrograde A-V nodal conduction times, refractory periods)surrogate

Verapamil has a direct effect on prolonging A-V nodal conduction that is independent of any vagotonic effect.

Cite This Study

Roy et al. (1974) studied this question.

synapsesocial.com/papers/6a8173d08412ed78203c3a47https://doi.org/10.1136/pgmj.50.583.270
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Also Consider

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

  1. 1The Essential Role of Atrioventricular Conduction Delay in the Initiation of Paroxysmal Supraventricular Tachycardia1971 · 218 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. 3Immediate Effects of Intravenous Verapamil in Cardiac Arrhythmias1972 · 309 citations
  4. 4Site of Reentry in Paroxysmal Supraventricular Tachycardia in Man1971 · 210 citations
  5. 5Study of Atrioventricular Conduction in Man Using Electrode Catheter Recordings of His Bundle Activity1969 · 172 citations