Control of heart rate during transition from intravenous to oral diltiazem in atrial fibrillation or flutter

The American Journal of Cardiology
J L BlackshearM K Ebener

Abstract

We tested whether patients presenting with atrial fibrillation (AF) or flutter (AFl) with a rapid ventricular response could maintain control of heart rate while transferring from a bolus and continuous infusion of intravenous diltiazem to oral diltiazem. Forty patients with AF or AFI and sustained ventricular rate > or = 120 beats/min received intravenous diltiazem "bolus" (20 to 25 mg for 2 minutes) and "infusion" (5 to 15 mg/hour for 6 to 20 hours). Oral long-acting diltiazem (diltiazem CD 180, 300, or 360 mg/24 hours) was administered in patients in whom stable heart rate control was attained during constant infusion. Intravenous diltiazem infusion was discontinued 4 hours after the first oral dose, and patients were monitored during 48 subsequent hours of "transition" to oral therapy. Response to diltiazem was defined as heart rate <100 beats/min, > or = 20% decrease in heart rate from baseline, or conversion to sinus rhythm. Other rate control or antiarrhythmic medications were not allowed during the study period. Thirty-seven of 40 patients maintained heart rate control during the bolus, and 35 of the remaining 37 maintained control during the infusion of intravenous diltiazem. Of the 35 patients achieving heart rate con...Continue Reading

References

Jun 4, 1992·The American Journal of Cardiology·B H Sarter, F E Marchlinski
Aug 1, 1991·Journal of the American College of Cardiology·S J ConnollyC Joyner
Apr 1, 1991·Annals of Internal Medicine·R H Falk, J I Leavitt
Nov 29, 1990·The New England Journal of Medicine·UNKNOWN Boston Area Anticoagulation Trial for Atrial Fibrillation InvestigatorsJ Philip Kistler
Jul 1, 1990·Journal of the American College of Cardiology·T Lundström, L Rydén

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Citations

Feb 28, 2002·Lancet·Nicholas S PetersVias Markides

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