Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1974 Jul;50(585):447–453. doi: 10.1136/pgmj.50.585.447

Verapamil in the treatment of paroxysmal supraventricular tachycardia

Dennis M Krikler, Roworth A J Spurrell
PMCID: PMC2495777  PMID: 4469035

Abstract

Verapamil is a novel antiarrhythmic agent which appears to act as a calcium-ion antagonist, blocking calcium transport across the myocardial cell membrane. It was given intravenously, in a dose of 10 mg, to thirty-two patients suffering from paroxysmal supraventricular tachycardia, and sinus rhythm was achieved promptly in all. Identical results were obtained in a further ten patients with supraventricular tachycardias associated with the Wolff-Parkinson-White or other pre-excitation syndromes. In a separate group of eighteen patients in whom A-V junctional tachycardias were induced during intracardiac electrography, conversion to sinus rhythm was achieved in fifteen patients, with prolongation of the cycle length in the others. Circus-movement tachycardias were induced in eight patients with the Wolff-Parkinson-White syndrome, and conversion to sinus rhythm was achieved in seven. The results were less consistent in patients with other supraventricular arrhythmias including ectopic atrial tachycardia and atrial flutter, and, in the single patient with supraventricular and ventricular tachycardia, only the former was controlled. In the single patient with atrial fibrillation complicating the Wolff-Parkinson-White syndrome who received verapamil, sinus rhythm was restored. Side effects were few and mild, with rare exceptions of profound hypotension, bradycardia and asystole; their management is discussed, and reasons are advanced why their occurrence is likely to be related either to the concomitant administration of beta-adrenergic blockers or to the presence of sinoatrial disease. It appears that verapamil is particularly suitable for the treatment of supraventricular tachycardias due to a circus movement as calcium antagonism is likely to be most effective in the N region of the atrioventricular node.

Full text

PDF
447

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abaza A., Bodinier C., Aziza C., Garnier J. C. Etude clinique d'un nouvel antiarythmique. Coeur Med Interne. 1972 Oct-Dec;11(4):757–763. [PubMed] [Google Scholar]
  2. Benaim M. E. Asystole after verapamil. Br Med J. 1972 Apr 15;2(5806):169–170. doi: 10.1136/bmj.2.5806.169-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bender F. Die behandlung der tachycarden Arrhythmien und der arteriellen Hypertonie mit Verapamil. Arzneimittelforschung. 1970 Sep;20(Suppl):1310+–1310+. [PubMed] [Google Scholar]
  4. Bender F., Kojima N., Reploh H. D., Oelmann G. Behandlung tachykarder Rhythmusstörungen des Herzens durch Beta-Rezeptorenblockade des Atrioventrikulargewebes. Med Welt. 1966 May 14;20:1120–1123. [PubMed] [Google Scholar]
  5. Brichard G., Zimmermann P. E. Verapamil in cardiac dysrhythmias during anaesthesia. Br J Anaesth. 1970 Nov;42(11):1005–1012. doi: 10.1093/bja/42.11.1005. [DOI] [PubMed] [Google Scholar]
  6. Filias N., Zanoni G. Klinisce Analyse der antiarrhythmischen Wirkung des Veramils. Schweiz Med Wochenschr. 1972 Mar 25;102(12):406–409. [PubMed] [Google Scholar]
  7. Fleckenstein A., Döring H. J., Kammermeier H. Einfluss von Beta-Receptorenblockern und verwandten Substanzen auf Erregung, Kontraktion und Energiestoffwechsel der Myokardfaser. Klin Wochenschr. 1968 Apr 1;46(7):343–351. doi: 10.1007/BF01734125. [DOI] [PubMed] [Google Scholar]
  8. Gotsman M. S., Lewis B. S., Bakst A., Mitha A. S. Verapamil in life-threatening tachyarrhythmias. S Afr Med J. 1972 Dec 23;46(51):2017–2019. [PubMed] [Google Scholar]
  9. HOFFMANN P. BEHANDLUNG KORONARER DURCHBLUTUNGSSTOERUNGEN MIT ISOPTIN IN DER PRAXIS. Med Klin. 1964 Aug 28;59:1387–1391. [PubMed] [Google Scholar]
  10. Husaini M. H., Kvasnicka J., Ryèn L., Holmberg S. Action of verapamil on sinus node, atrioventricular, and intraventricular conduction. Br Heart J. 1973 Jul;35(7):734–737. doi: 10.1136/hrt.35.7.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kaumann A. J., Aramendía P. Prevention of ventricular fibrillation induced by coronary ligation. J Pharmacol Exp Ther. 1968 Dec;164(2):326–332. [PubMed] [Google Scholar]
  12. MELVILLE K. I., SHISTER H. E., HUQ S. IPROVERATRIL: EXPERIMENTAL DATA ON CORONARY DILATATION AND ANTIARRHYTHMIC ACTION. Can Med Assoc J. 1964 Mar 28;90:761–770. [PMC free article] [PubMed] [Google Scholar]
  13. Milne J. R., Boothby C. B., Garrard C. S., Pickering D. Verapamil in cardiac arrhythmias. Br Med J. 1972 May 6;2(5809):348–349. doi: 10.1136/bmj.2.5809.348-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Nayler W. G., McInnes I., Swann J. B., Price J. M., Carson V., Race D., Lowe T. E. Some effects of iproveratril (Isoptin) on the cardiovascular system. J Pharmacol Exp Ther. 1968 Jun;161(2):247–261. [PubMed] [Google Scholar]
  15. Nayler W. G., Szeto J. Effect of verapamil on contractility, oxygen utilization, and calcium exchangeability in mammalian heart muscle. Cardiovasc Res. 1972 Mar;6(2):120–128. doi: 10.1093/cvr/6.2.120. [DOI] [PubMed] [Google Scholar]
  16. Sacks H., Kennelly B. M. Verapamil in cardiac arrhythmias. Br Med J. 1972 Jun 17;2(5815):716–716. doi: 10.1136/bmj.2.5815.716-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schamroth L. Immediate effects of intravenous verapamil on atrial fibrillation. Cardiovasc Res. 1971 Oct;5(4):419–424. doi: 10.1093/cvr/5.4.419. [DOI] [PubMed] [Google Scholar]
  18. Schamroth L., Krikler D. M., Garrett C. Immediate effects of intravenous verapamil in cardiac arrhythmias. Br Med J. 1972 Mar 11;1(5801):660–662. doi: 10.1136/bmj.1.5801.660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Schmid J. R., Hanna C. A comparison of the antiarrhythmic actions of two new synthetic compounds, iproveratril and MJ 1999, with quinidine and pronethalol. J Pharmacol Exp Ther. 1967 May;156(2):331–338. [PubMed] [Google Scholar]
  20. Singh B. N. A fourth class of anti-dysrhythmic action? Effect of verapamil on ouabain toxicity, on atrial and ventricular intracellular potentials, and on other features of cardiac function. Cardiovasc Res. 1972 Mar;6(2):109–119. doi: 10.1093/cvr/6.2.109. [DOI] [PubMed] [Google Scholar]
  21. Spurrell R. A., Krikler D. M., Sowton E. Effects of verapamil on electrophysiological properties of anomalous atrioventricular connexion in Wolff-Parkinson-White syndrome. Br Heart J. 1974 Mar;36(3):256–264. doi: 10.1136/hrt.36.3.256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Spurrell R. A., Krikler D., Sowton E. Two or more intra AV nodal pathways in association with either a James or Kent extranodal bypass in 3 patients with paroxysmal supraventricular tachycardia. Br Heart J. 1973 Feb;35(2):113–122. doi: 10.1136/hrt.35.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. TSCHIRDEWAHN B., KLEPZIG H. KLINISCHE UNTERSUCHUNG UEBER DIE WIRKUNG VON ISOPTIN UND ISOPTIN S BEI PATIENTEN MIT KORONARINSUFFIZIENZ. Dtsch Med Wochenschr. 1963 Aug 30;88:1702–1707. doi: 10.1055/s-0028-1112284. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES