TY - JOUR
T1 - Effects of verapamil on supraventricular tachycardia in children
AU - Porter, Co burn J.
AU - Gillette, Paul C.
AU - Garson, Arthur
AU - Hesslein, Peter S.
AU - Karpawich, Peter P.
AU - McNamara, Dan G.
N1 - Funding Information:
From the Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas. This study was supported in part by four grants from the National Institutes of Health, Bethesda, Maryland: General Clinic Research Branch Grant RR-00166. U. S. Public Health Service &ant K-07 190, Research Career Development Award l-H-00571 (Dr. Gillette) and Young Investigator Award m-24916 (Dr. Barson), and by a grant from the J. S. Abercrombie Foundation, Houston, Texas. Manuscript received January 19. 1961; revised manuscript received April 6, 1961; accepted April 24, 1961. Address for reprints: Co-burn J. Porter, MD. Section of Pedfftric Cardiology, Texas Children’s Hospital, 6621 Fannin. Houston, Texas 77030.
PY - 1981/9
Y1 - 1981/9
N2 - Thirteen patients, aged 6 weeks to 16 years, with uncontrolled recurrent Supraventricular tachycardia were given intravenous verapamil in an attempt to abolish an episode of Supraventricular tachycardia. All patients had had intracardiac electrophysiologic studies to define the mechanism of their tachycardia. In seven patients conversion to sinus rhythm occurred after administration of verapamil: Five of the seven had atrioventricular (A-V) nodal reentry as the mechanism of their supraventricular tachycardia; the other two had reentrant tachycardia involving an accessory pathway. Verapamil was effective in abolishing the Supraventricular tachycardia in these patients, probably by prolonging the A-V nodal refractory period and conduction, thus breaking the reentrant circuit. In six patients there was no conversion to sinus rhythm: Four of the six had automatic atrial ectopic tachycardia and two had automatic junctional ectopic tachycardia. Among the four patients with automatic atrial ectopic tachycardia, a junctional escape rhythm developed in one, and second degree A-V block developed in the others. The two patients with junctional ectopic tachycardia had severe symptomatic arterial hypotension after verapamil and required resuscitation with intravenous calcium chloride. In spite of the good response to intravenous verapamil in the seven patients with reentrant tachycardia, only four of the seven could be maintained successfully on long-term oral therapy. The patients who experienced conversion to sinus rhythm with an intravenous bolus dose of verapamil but in whom Supraventricular tachycardia could still be induced with programmed stimulation could not be maintained successfully on oral therapy. It is concluded that verapamil is an effective antiarrhythmic agent that can (1) abolish the acute episode of Supraventricular tachycardia only in cases due to reentrant mechanisms, and (2) be used as an oral medication to prevent recurrences of supraventricular tachycardia in patients in whom the arrhythmia cannot be induced with programmed stimulation after intravenous doses of the drug.
AB - Thirteen patients, aged 6 weeks to 16 years, with uncontrolled recurrent Supraventricular tachycardia were given intravenous verapamil in an attempt to abolish an episode of Supraventricular tachycardia. All patients had had intracardiac electrophysiologic studies to define the mechanism of their tachycardia. In seven patients conversion to sinus rhythm occurred after administration of verapamil: Five of the seven had atrioventricular (A-V) nodal reentry as the mechanism of their supraventricular tachycardia; the other two had reentrant tachycardia involving an accessory pathway. Verapamil was effective in abolishing the Supraventricular tachycardia in these patients, probably by prolonging the A-V nodal refractory period and conduction, thus breaking the reentrant circuit. In six patients there was no conversion to sinus rhythm: Four of the six had automatic atrial ectopic tachycardia and two had automatic junctional ectopic tachycardia. Among the four patients with automatic atrial ectopic tachycardia, a junctional escape rhythm developed in one, and second degree A-V block developed in the others. The two patients with junctional ectopic tachycardia had severe symptomatic arterial hypotension after verapamil and required resuscitation with intravenous calcium chloride. In spite of the good response to intravenous verapamil in the seven patients with reentrant tachycardia, only four of the seven could be maintained successfully on long-term oral therapy. The patients who experienced conversion to sinus rhythm with an intravenous bolus dose of verapamil but in whom Supraventricular tachycardia could still be induced with programmed stimulation could not be maintained successfully on oral therapy. It is concluded that verapamil is an effective antiarrhythmic agent that can (1) abolish the acute episode of Supraventricular tachycardia only in cases due to reentrant mechanisms, and (2) be used as an oral medication to prevent recurrences of supraventricular tachycardia in patients in whom the arrhythmia cannot be induced with programmed stimulation after intravenous doses of the drug.
UR - http://www.scopus.com/inward/record.url?scp=0019415908&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(81)90077-1
DO - 10.1016/0002-9149(81)90077-1
M3 - Article
C2 - 7270455
AN - SCOPUS:0019415908
VL - 48
SP - 487
EP - 491
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
SN - 0002-9149
IS - 3
ER -