Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia
Atrioventricular (AV) conduction, ventriculoatrial (VA) conduction, and the mechanism of tachycardia, were studied by programmed electrical stimulation before and after the administration of verapamil, in 10 patients with paroxysmal re-entrant supraventricular tachycardia. In 7 patients the tachycar...
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| Veröffentlicht in: | British Heart Journal 1977-10, Vol.39 (10), p.1058-1066 |
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| creator | Wellens, H J Tan, S L Bär, F W Düren, D R Lie, K I Dohmen, H M |
| description | Atrioventricular (AV) conduction, ventriculoatrial (VA) conduction, and the mechanism of tachycardia, were studied by programmed electrical stimulation before and after the administration of verapamil, in 10 patients with paroxysmal re-entrant supraventricular tachycardia. In 7 patients the tachycardia circuit was confined to the AV node. In 3 patients an accessory pathway conducting only in the ventriculoatrial direction was used during tachycardia. When administered intravenously during tachycardia, verapamil terminated the arrhythmia in 9 patients. Verapamil lengthened the effective and the functional refractory period of the AV node and the AV nodal transmission time in all patients in whom this could be studied. As a result of these changes, it was not possible to initiate tachycardia in 3 patients. The width of the zone of atrial premature beats able to initiate tachycardia (the tachycardia zone) narrowed in 5 patients, and increased in 2 patients. In 6 of these 7 patients the tachycardia zone shifted to longer premature beat intervals. Verapamil resulted in slowing of the heart rate during tachycardia. Apart from slowing in heart rate during tachycardia and termination of tachycardia after intravenous verapamil, the 3 patients with an accessory pathway showed no beneficial effect of verapamil on the mechanism of initiation of tachycardia. Five patients were restudied after 2 to 3 weeks of oral administration of verapamil. Though less, effects were similar to those obtained after intravenous administration. |
| doi_str_mv | 10.1136/hrt.39.10.1058 |
| format | Article |
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In 7 patients the tachycardia circuit was confined to the AV node. In 3 patients an accessory pathway conducting only in the ventriculoatrial direction was used during tachycardia. When administered intravenously during tachycardia, verapamil terminated the arrhythmia in 9 patients. Verapamil lengthened the effective and the functional refractory period of the AV node and the AV nodal transmission time in all patients in whom this could be studied. As a result of these changes, it was not possible to initiate tachycardia in 3 patients. The width of the zone of atrial premature beats able to initiate tachycardia (the tachycardia zone) narrowed in 5 patients, and increased in 2 patients. In 6 of these 7 patients the tachycardia zone shifted to longer premature beat intervals. Verapamil resulted in slowing of the heart rate during tachycardia. Apart from slowing in heart rate during tachycardia and termination of tachycardia after intravenous verapamil, the 3 patients with an accessory pathway showed no beneficial effect of verapamil on the mechanism of initiation of tachycardia. Five patients were restudied after 2 to 3 weeks of oral administration of verapamil. Though less, effects were similar to those obtained after intravenous administration.</description><identifier>ISSN: 0007-0769</identifier><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>EISSN: 2053-5864</identifier><identifier>DOI: 10.1136/hrt.39.10.1058</identifier><identifier>PMID: 911555</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Adult ; Atrioventricular Node - physiopathology ; Cardiac Pacing, Artificial ; Female ; Heart Conduction System - drug effects ; Humans ; Male ; Middle Aged ; Tachycardia, Paroxysmal - drug therapy ; Tachycardia, Paroxysmal - physiopathology ; Verapamil - pharmacology ; Verapamil - therapeutic use</subject><ispartof>British Heart Journal, 1977-10, Vol.39 (10), p.1058-1066</ispartof><rights>Copyright BMJ Publishing Group LTD Oct 1977</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b483t-1dee2f9a707e6e96b512c167626d06de65b2858f0c5a641e6e1dcf08d5ea89073</citedby><cites>FETCH-LOGICAL-b483t-1dee2f9a707e6e96b512c167626d06de65b2858f0c5a641e6e1dcf08d5ea89073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC483370/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC483370/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/911555$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wellens, H J</creatorcontrib><creatorcontrib>Tan, S L</creatorcontrib><creatorcontrib>Bär, F W</creatorcontrib><creatorcontrib>Düren, D R</creatorcontrib><creatorcontrib>Lie, K I</creatorcontrib><creatorcontrib>Dohmen, H M</creatorcontrib><title>Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia</title><title>British Heart Journal</title><addtitle>Br Heart J</addtitle><description>Atrioventricular (AV) conduction, ventriculoatrial (VA) conduction, and the mechanism of tachycardia, were studied by programmed electrical stimulation before and after the administration of verapamil, in 10 patients with paroxysmal re-entrant supraventricular tachycardia. In 7 patients the tachycardia circuit was confined to the AV node. In 3 patients an accessory pathway conducting only in the ventriculoatrial direction was used during tachycardia. When administered intravenously during tachycardia, verapamil terminated the arrhythmia in 9 patients. Verapamil lengthened the effective and the functional refractory period of the AV node and the AV nodal transmission time in all patients in whom this could be studied. As a result of these changes, it was not possible to initiate tachycardia in 3 patients. The width of the zone of atrial premature beats able to initiate tachycardia (the tachycardia zone) narrowed in 5 patients, and increased in 2 patients. In 6 of these 7 patients the tachycardia zone shifted to longer premature beat intervals. Verapamil resulted in slowing of the heart rate during tachycardia. Apart from slowing in heart rate during tachycardia and termination of tachycardia after intravenous verapamil, the 3 patients with an accessory pathway showed no beneficial effect of verapamil on the mechanism of initiation of tachycardia. Five patients were restudied after 2 to 3 weeks of oral administration of verapamil. Though less, effects were similar to those obtained after intravenous administration.</description><subject>Adult</subject><subject>Atrioventricular Node - physiopathology</subject><subject>Cardiac Pacing, Artificial</subject><subject>Female</subject><subject>Heart Conduction System - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Tachycardia, Paroxysmal - drug therapy</subject><subject>Tachycardia, Paroxysmal - physiopathology</subject><subject>Verapamil - pharmacology</subject><subject>Verapamil - therapeutic use</subject><issn>0007-0769</issn><issn>1355-6037</issn><issn>1468-201X</issn><issn>2053-5864</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1977</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkTuP1DAUhS3Ea1hoqSgsISFRZLCTsR0XFGi0PKRhKVgQneU4zsZDEgfbGXZ-Bv-Ym81qBDRU1vH5zn3oIvSUkjWlBX_VhrQu5HqWhJV30IpueJnlhH67i1aEEJERweVD9CjGPciNLPkDdF9SyhhboV_nTWNNwr7BBxv0qHvX4Zim2tkaV0c8Bn8VdN-Dsh2AwRk9A66fOp2cH-Zkai1urQ4JuwGP8G2HFPFPl1pQwV8fYw-hYDP4D3pIOE5j0IdZOQN1Ak7atEejQ-30Y3Sv0V20T27fM_Tl7fnl9n22-_Tuw_bNLqs2ZZEyWlubN1ILIiy3kleM5oZywXNeE15bzqq8ZGVDDNN8Q4GhtWlIWTOrS0lEcYZeL3XHqYL1zM1snRqD63U4Kq-d-tsZXKuu_EFB-0IQyL-4zQf_Y7Ixqd5FY7tOD9ZPUQmAqNzMjZ7_A-79FAbYTVEhCJHAcaDWC2WCjzHY5jQJJWo-tIJDq0LeSDg0BJ79Of8JXy4LdrbYLiZ7fXJ1-K44jMbUxdetEpcXbLvjH9Vn4F8ufNXv_9f6N3-0xYc</recordid><startdate>19771001</startdate><enddate>19771001</enddate><creator>Wellens, H J</creator><creator>Tan, S L</creator><creator>Bär, F W</creator><creator>Düren, D R</creator><creator>Lie, K I</creator><creator>Dohmen, H M</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19771001</creationdate><title>Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia</title><author>Wellens, H J ; Tan, S L ; Bär, F W ; Düren, D R ; Lie, K I ; Dohmen, H M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b483t-1dee2f9a707e6e96b512c167626d06de65b2858f0c5a641e6e1dcf08d5ea89073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1977</creationdate><topic>Adult</topic><topic>Atrioventricular Node - physiopathology</topic><topic>Cardiac Pacing, Artificial</topic><topic>Female</topic><topic>Heart Conduction System - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Tachycardia, Paroxysmal - drug therapy</topic><topic>Tachycardia, Paroxysmal - physiopathology</topic><topic>Verapamil - pharmacology</topic><topic>Verapamil - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wellens, H J</creatorcontrib><creatorcontrib>Tan, S L</creatorcontrib><creatorcontrib>Bär, F W</creatorcontrib><creatorcontrib>Düren, D R</creatorcontrib><creatorcontrib>Lie, K I</creatorcontrib><creatorcontrib>Dohmen, H M</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British Heart Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wellens, H J</au><au>Tan, S L</au><au>Bär, F W</au><au>Düren, D R</au><au>Lie, K I</au><au>Dohmen, H M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia</atitle><jtitle>British Heart Journal</jtitle><addtitle>Br Heart J</addtitle><date>1977-10-01</date><risdate>1977</risdate><volume>39</volume><issue>10</issue><spage>1058</spage><epage>1066</epage><pages>1058-1066</pages><issn>0007-0769</issn><issn>1355-6037</issn><eissn>1468-201X</eissn><eissn>2053-5864</eissn><abstract>Atrioventricular (AV) conduction, ventriculoatrial (VA) conduction, and the mechanism of tachycardia, were studied by programmed electrical stimulation before and after the administration of verapamil, in 10 patients with paroxysmal re-entrant supraventricular tachycardia. In 7 patients the tachycardia circuit was confined to the AV node. In 3 patients an accessory pathway conducting only in the ventriculoatrial direction was used during tachycardia. When administered intravenously during tachycardia, verapamil terminated the arrhythmia in 9 patients. Verapamil lengthened the effective and the functional refractory period of the AV node and the AV nodal transmission time in all patients in whom this could be studied. As a result of these changes, it was not possible to initiate tachycardia in 3 patients. The width of the zone of atrial premature beats able to initiate tachycardia (the tachycardia zone) narrowed in 5 patients, and increased in 2 patients. In 6 of these 7 patients the tachycardia zone shifted to longer premature beat intervals. Verapamil resulted in slowing of the heart rate during tachycardia. Apart from slowing in heart rate during tachycardia and termination of tachycardia after intravenous verapamil, the 3 patients with an accessory pathway showed no beneficial effect of verapamil on the mechanism of initiation of tachycardia. Five patients were restudied after 2 to 3 weeks of oral administration of verapamil. Though less, effects were similar to those obtained after intravenous administration.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>911555</pmid><doi>10.1136/hrt.39.10.1058</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Atrioventricular Node - physiopathology Cardiac Pacing, Artificial Female Heart Conduction System - drug effects Humans Male Middle Aged Tachycardia, Paroxysmal - drug therapy Tachycardia, Paroxysmal - physiopathology Verapamil - pharmacology Verapamil - therapeutic use |
| title | Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia |
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