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Effect of Verapamil on Immediate Recurrence of Atrial Fibrillation
Author(s) -
DAOUD EMILE G.,
HUMMEL JOHN D.,
AUGOSTINI RALPH,
WILLIAMS STACY,
KALBFLEISCH STEVEN J.
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2000.01231.x
Subject(s) - medicine , verapamil , atrial fibrillation , cardioversion , sinus rhythm , cardiology , anesthesia , calcium
Immediate Recurrence of AF. Introduction: The purpose of this study was to assess the effect of verapamil on immediate recurrences of atrial fibrillation occurring after successful electrical cardioversion. Methods and Results: The effect of verapamil on the recurrence of atrial fibrillation within 5 minutes after successful transthoracic cardioversion was assessed in 19 (5%) of 364 patients undergoing electrical cardioversion. The mean duration of atrial fibrillation was 4.44 ± 3.0 months. In the 19 patients, cardioversion was successful after each of three consecutive cardioversion attempts per patient; however, atrial fibrillation recurred 0.4 ± 0.3 minutes after cardioversion. Verapamil 10 mg was administered intravenously and fourth cardioversion was performed. Cardioversion after verapamil was successful in each patient, and atrial fibrillation did not recur in 9 (47%) of 19 patients (P < 0.001 vs before verapamil). In the remaining 10 patients in whom atrial fibrillation recurred, the duration of sinus rhythm was significantly longer compared with before verapamil (3,6 ± 2.4 min, P < 0.001). The density of atrial ectopy occurring after cardioversion was significantly less after verapamil (21 ± 14 ectopic beats per min) compared with before verapamil (123 ± 52 ectopic beats per min, P < 0.001). Conclusion: Among patients with immediate recurrence of atrial fibrillation after electrical cardioversion, acute calcium channel blockade by verapamil reduces recurrence of atrial fibrillation and extends the duration of sinus rhythm.