EFFECTS OF INTRAVENOUS VERAPAMIL ON ATRIAL VULNERABILITY

概要

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To investigate the effects of verapamil on indicators of atrial vulnerability, we examined 30 patients with paroxysmal supraventricular tachycardia who received intravenous verapamil during an electrophysiologic study. Single atrial extrastimuli were given before and after intravenous administration of verapamil to induce repetitive atrial firing (RAF) or atrial fibrillation, and to examine the maximum A_2/A_1, which was defined as the maximum ratio of the duration of the atrial electrogram resulting from premature stimulation (A_2) to that resulting from the basic drive beat (A_1). The maximum A_2/A_1 increased from 145±20% to 154±25% (p<0.02) after verapamil administration. The maximum A_2/A_1 in patients in whom neither RAF nor atrial fibrillation were induced both before and after verapamil were smaller than those in patients in whom RAF was induced only after verapamil (before; 138±20% vs 165±15% , p<0.02. after; 144±22% vs 172±17%, p<0.05). RAF or atrial fibrillation was induced only after verapamil in 6 patients, who showed a maximum A_2/A_1 before verapamil of 150% or more. These data suggest that verapamil may induce repetitive atrial firing and possibly atrial fibrillation in some predisposed patients, especially in those that have a greater maximum A_2/A_1, which may be an indicator of local intraatrial conduction delay before drug infusion.
社団法人日本循環器学会の論文
1993-12-20