Continuous infusion of edrophonium (Tensilon) in treating supraventricular arrhythmias

Ten patients with atrial flutter or fibrillation and ventricular rates of greater than 140 beats/min were treated with a continuous infusion of 0.25 to 2.0 mg/min of edrophonium chloride (Tensilon), after an initial bolus of 5 to 10 mg had produced transient ventricular slowing. In 9 of these patients digitalis had been administered without a significant decrease in ventricular rate, and further digitalis was considered potentially dangerous. Four additional patients with supraventricular tachycardias, all receiving digitalis, received a bolus and then continuous edrophonium infusion. In all 14 patients edrophonium infused for periods of up to 30 hours was effective in maintaining a slowed ventricular rate with clinical improvement. There were no significant side effects.