Why the study?
Does intravenous verapamil paradoxically induce PSVT during electrophysiological stimulation in patients with a history of PSVT?
Does intravenous verapamil paradoxically induce PSVT during electrophysiological stimulation in patients with a history of PSVT?
Intravenous verapamil may paradoxically induce PSVT during electrophysiological stimulation, highlighting a potential adverse effect dependent on AV nodal conduction changes.
Verapamil may paradoxically induce PSVT during EP stimulation; hypothesis-generating observation that should not yet change practice.
The intravenous administration of verapamil to 2 patients with paroxysmal supraventricular tachycardia (PSVT) resulted in an induction of PSVT during a programmed electrophysiological stimulation study. Each patient had a documented episode of PSVT. Baseline programmed stimulation studies revealed neither induction of PSVT nor an atrial echo; however, PSVT was induced immediately after injecting verapamil (0.15 mg/kg) intravenously in both patients. In 1 patient, the study was repeated 2 days later and similar results were obtained. The serum concentration of verapamil when PSVT was induced was about 80 ng/ml in both cases. Clinicians using verapamil should note that this antiarrhythmic drug may aggravate PSVT, depending on critical changes in AV nodal conduction and refractoriness.
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Saikawa et al. (1987) studied this question.
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