PMID: 3662276Nov 1, 1987Paper

Intravenous verapamil for treatment of multifocal atrial tachycardia with and without calcium pretreatment

Annals of Internal Medicine
D M SalernoC Iber

Abstract

Verapamil was given to 16 consecutive patients with multifocal atrial tachycardia. Intravenous verapamil was administered at a rate of up to 1 mg/min while heart rate and systolic blood pressure were being monitored. The final 5 patients received 1 g of intravenous calcium gluconate 5 minutes before treatment with verapamil; the first 11 received no calcium. The mean +/- SD heart rate decreased by 21% from 129 to 101 beats/min, a difference of 28, 95% confidence interval (CI), 18 to 38 (p less than 0.0005 by t-test), after a mean of 22 +/- 13 minutes from the start of verapamil administration. The mean verapamil dose was 17 +/- 7 mg (6 to 30 mg). Sinus rhythm was restored in 8 patients. Pretreatment with calcium did not block the effect of verapamil on heart rate (27% decrease with calcium compared with 19% decrease without calcium, a difference of 8%, 95% CI, -7 to 23; p = 0.29) but minimized the decrease in systolic pressure (11% decrease with calcium compared with 27% decrease without calcium, a difference of 16%, 95% CI, 7 to 27; p less than 0.01). Verapamil caused transient asymptomatic hypotension in 1 patient. Arterial blood gases were unchanged by verapamil. Thus, verapamil is safe and effective therapy for multifocal a...Continue Reading

Citations

Oct 11, 1991·Journal of the American College of Cardiology·D H WohnsK F Adams
Jan 1, 1989·The Journal of Emergency Medicine·G P Moore, D W Munter
Jan 19, 1995·The New England Journal of Medicine·L I Ganz, P L Friedman
Jul 1, 1995·The American Journal of Emergency Medicine·R B Vukmir
Jul 1, 1992·American Heart Journal·M Kuhn, D L Schriger
Jul 1, 1992·Current Problems in Cardiology·D E Haines, J P DiMarco
May 1, 1994·The Journal of Emergency Medicine·M SchwartzS R Lowenstein
Jan 1, 1992·Annals of Emergency Medicine·S J Jameson, S W Hargarten
Sep 1, 1989·American Heart Journal·D L Scher, E L Arsura
Jul 29, 2018·American Journal of Medical Genetics. Part a·Mark D LevinAngela E Lin
Oct 1, 1989·Postgraduate Medicine·S L Lawhorn, W W Emmot
Jun 14, 2000·The Annals of Pharmacotherapy·L R MoserJ E Tisdale
Jun 14, 1990·The New England Journal of Medicine·J A Kastor
May 1, 1992·Postgraduate Medicine·D M Salerno

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