Comparison of intravenous diltiazem and verapamil for the acute treatment of atrial fibrillation and atrial flutter.

摘要: Study Objectives. To compare the efficacy and safety of intravenous diltiazem verapamil in controlling ventricular rate patients with atrial fibrillation or flutter, to evaluate effects these agents on left systolic function. Design. Prospective, randomized, double-blind, crossover study. Setting. University-affiliated hospital Veterans Administration hospital. Patients. Seventeen men flutter a 120 beats/minute higher blood pressure 100 mm Hg greater. Interventions. Patients received up two boluses either verapamil, followed by an 8-hour continuous infusion if therapeutic response was achieved (phase I). After washout period, who responded were crossed over receive other drug similar fashion II). Measurements Main Results. At end each infusion, patient's ejection fraction assessed gated angiography. Of 17 initially 8 successfully completed both phases I II. In patients, baseline mean (± SD) rates before treatment 138 ± 15 132 9 beats/minute, respectively (NS). 2 minutes after initial bolus dose, decreased 13 group compared 114 those receiving (p<0.05). Mean 96 11 97 maintained during On completion dose(s) infusions, there no significant differences pressures between groups. fractions 35.6 13.6% 35.5 15.4% groups, For maximum percentage decreases not significantly different However, three developed symptomatic hypotension all whom randomized initially. Conclusion. Intravenous are comparable terms effect function rapid flutter. may limit therapy some patients.