Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias

R. L. Rinkenberger, E. N. Prystowsky, J. J. Heger, P. J. Troup, W. M. Jackman, D. P. Zipes

Research output: Contribution to journalArticle

195 Citations (Scopus)

Abstract

The efficacy of i.v. and oral verapamil was studied in 28 patients with supraventricular tachycardia (SVT). Verapamil (5-10 mg i.v.) terminated SVT in all six patients with atrioventricular nodal (AVN) reentrant tachycardia. In all patients verapamil prolonged antegrade but did not affect retrograde AVN conduction time. Two patients had associated sinus nodal reentrant tachycardia that persisted after the AVN tachycardia terminated. In six patients with SVT using an accessory pathway for retrograde conduction, i.v. verapamil terminated SVT in four and slowed SVT in two patients. Verapamil did not affect the electrophysiologic properties of the accessory pathway and the effect on the SVT, as with AVN reentry, was caused by changes in antegrade AVN function. Verapamil lengthened AVN antegrade conduction time in patients with accessory pathways less than it did in patients with AVN reentry. Verapamil at doses that resulted AVN Wenckebach block had no effect on the discharge rate of the three patients with automatic atrial tachycardia. In 13 of 14 patients with atrial fibrillation or flutter, i.v. verapamil promptly decreased the ventricular rate. One patient with preexitation had an increase in ventricular rate after verapamil. The shortest RR intervals before and after verapamil were 260 and 220 msec, respectively, and after verapamil more ventricular beats were preexcited. Oral verapamil was given to 19 of 28 patients. Ten discontinued the drug within 30 days because of side effects or ineffectiveness. Seven patients treated for a mean of 19 months have shown evidence of improvement, judged by decreased frequency and shorter duration of tachycardia when it did recur. Thus, i.v. verapamil is an effective antiarrhythmic drug for most patients with SVT, but oral verapamil is effective in only selected patients.

Original languageEnglish (US)
Pages (from-to)996-1010
Number of pages15
JournalCirculation
Volume62
Issue number5
StatePublished - 1980
Externally publishedYes

Fingerprint

Verapamil
Tachycardia
Oral Administration
Supraventricular Tachycardia
Atrioventricular Nodal Reentry Tachycardia
Atrial Flutter
Anti-Arrhythmia Agents
Atrial Fibrillation

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Rinkenberger, R. L., Prystowsky, E. N., Heger, J. J., Troup, P. J., Jackman, W. M., & Zipes, D. P. (1980). Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias. Circulation, 62(5), 996-1010.

Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias. / Rinkenberger, R. L.; Prystowsky, E. N.; Heger, J. J.; Troup, P. J.; Jackman, W. M.; Zipes, D. P.

In: Circulation, Vol. 62, No. 5, 1980, p. 996-1010.

Research output: Contribution to journalArticle

Rinkenberger, RL, Prystowsky, EN, Heger, JJ, Troup, PJ, Jackman, WM & Zipes, DP 1980, 'Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias', Circulation, vol. 62, no. 5, pp. 996-1010.
Rinkenberger RL, Prystowsky EN, Heger JJ, Troup PJ, Jackman WM, Zipes DP. Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias. Circulation. 1980;62(5):996-1010.
Rinkenberger, R. L. ; Prystowsky, E. N. ; Heger, J. J. ; Troup, P. J. ; Jackman, W. M. ; Zipes, D. P. / Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias. In: Circulation. 1980 ; Vol. 62, No. 5. pp. 996-1010.
@article{c6a0c9af8b2c4beaabb546fca14b0bd4,
title = "Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias",
abstract = "The efficacy of i.v. and oral verapamil was studied in 28 patients with supraventricular tachycardia (SVT). Verapamil (5-10 mg i.v.) terminated SVT in all six patients with atrioventricular nodal (AVN) reentrant tachycardia. In all patients verapamil prolonged antegrade but did not affect retrograde AVN conduction time. Two patients had associated sinus nodal reentrant tachycardia that persisted after the AVN tachycardia terminated. In six patients with SVT using an accessory pathway for retrograde conduction, i.v. verapamil terminated SVT in four and slowed SVT in two patients. Verapamil did not affect the electrophysiologic properties of the accessory pathway and the effect on the SVT, as with AVN reentry, was caused by changes in antegrade AVN function. Verapamil lengthened AVN antegrade conduction time in patients with accessory pathways less than it did in patients with AVN reentry. Verapamil at doses that resulted AVN Wenckebach block had no effect on the discharge rate of the three patients with automatic atrial tachycardia. In 13 of 14 patients with atrial fibrillation or flutter, i.v. verapamil promptly decreased the ventricular rate. One patient with preexitation had an increase in ventricular rate after verapamil. The shortest RR intervals before and after verapamil were 260 and 220 msec, respectively, and after verapamil more ventricular beats were preexcited. Oral verapamil was given to 19 of 28 patients. Ten discontinued the drug within 30 days because of side effects or ineffectiveness. Seven patients treated for a mean of 19 months have shown evidence of improvement, judged by decreased frequency and shorter duration of tachycardia when it did recur. Thus, i.v. verapamil is an effective antiarrhythmic drug for most patients with SVT, but oral verapamil is effective in only selected patients.",
author = "Rinkenberger, {R. L.} and Prystowsky, {E. N.} and Heger, {J. J.} and Troup, {P. J.} and Jackman, {W. M.} and Zipes, {D. P.}",
year = "1980",
language = "English (US)",
volume = "62",
pages = "996--1010",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Effects of intravenous and chronic oral verapamil administration in patients with supraventricular tachyarrhythmias

AU - Rinkenberger, R. L.

AU - Prystowsky, E. N.

AU - Heger, J. J.

AU - Troup, P. J.

AU - Jackman, W. M.

AU - Zipes, D. P.

PY - 1980

Y1 - 1980

N2 - The efficacy of i.v. and oral verapamil was studied in 28 patients with supraventricular tachycardia (SVT). Verapamil (5-10 mg i.v.) terminated SVT in all six patients with atrioventricular nodal (AVN) reentrant tachycardia. In all patients verapamil prolonged antegrade but did not affect retrograde AVN conduction time. Two patients had associated sinus nodal reentrant tachycardia that persisted after the AVN tachycardia terminated. In six patients with SVT using an accessory pathway for retrograde conduction, i.v. verapamil terminated SVT in four and slowed SVT in two patients. Verapamil did not affect the electrophysiologic properties of the accessory pathway and the effect on the SVT, as with AVN reentry, was caused by changes in antegrade AVN function. Verapamil lengthened AVN antegrade conduction time in patients with accessory pathways less than it did in patients with AVN reentry. Verapamil at doses that resulted AVN Wenckebach block had no effect on the discharge rate of the three patients with automatic atrial tachycardia. In 13 of 14 patients with atrial fibrillation or flutter, i.v. verapamil promptly decreased the ventricular rate. One patient with preexitation had an increase in ventricular rate after verapamil. The shortest RR intervals before and after verapamil were 260 and 220 msec, respectively, and after verapamil more ventricular beats were preexcited. Oral verapamil was given to 19 of 28 patients. Ten discontinued the drug within 30 days because of side effects or ineffectiveness. Seven patients treated for a mean of 19 months have shown evidence of improvement, judged by decreased frequency and shorter duration of tachycardia when it did recur. Thus, i.v. verapamil is an effective antiarrhythmic drug for most patients with SVT, but oral verapamil is effective in only selected patients.

AB - The efficacy of i.v. and oral verapamil was studied in 28 patients with supraventricular tachycardia (SVT). Verapamil (5-10 mg i.v.) terminated SVT in all six patients with atrioventricular nodal (AVN) reentrant tachycardia. In all patients verapamil prolonged antegrade but did not affect retrograde AVN conduction time. Two patients had associated sinus nodal reentrant tachycardia that persisted after the AVN tachycardia terminated. In six patients with SVT using an accessory pathway for retrograde conduction, i.v. verapamil terminated SVT in four and slowed SVT in two patients. Verapamil did not affect the electrophysiologic properties of the accessory pathway and the effect on the SVT, as with AVN reentry, was caused by changes in antegrade AVN function. Verapamil lengthened AVN antegrade conduction time in patients with accessory pathways less than it did in patients with AVN reentry. Verapamil at doses that resulted AVN Wenckebach block had no effect on the discharge rate of the three patients with automatic atrial tachycardia. In 13 of 14 patients with atrial fibrillation or flutter, i.v. verapamil promptly decreased the ventricular rate. One patient with preexitation had an increase in ventricular rate after verapamil. The shortest RR intervals before and after verapamil were 260 and 220 msec, respectively, and after verapamil more ventricular beats were preexcited. Oral verapamil was given to 19 of 28 patients. Ten discontinued the drug within 30 days because of side effects or ineffectiveness. Seven patients treated for a mean of 19 months have shown evidence of improvement, judged by decreased frequency and shorter duration of tachycardia when it did recur. Thus, i.v. verapamil is an effective antiarrhythmic drug for most patients with SVT, but oral verapamil is effective in only selected patients.

UR - http://www.scopus.com/inward/record.url?scp=0019174455&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019174455&partnerID=8YFLogxK

M3 - Article

VL - 62

SP - 996

EP - 1010

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 5

ER -