title: Misuse of verapamil in pre-excited atrial fibrillation.
abstract: Of 18 patients who attended accident and emergency departments with pre-excited atrial fibrillation, 10 were inappropriately treated with intravenous verapamil. The reason for the inappropriate treatment was misdiagnosis of the arrhythmia, although diagnostic electrocardiograms were available for all patients: in only 3 of the 18 patients was the correct diagnosis made before intervention. Misdiagnosis occurred because of failure to consider pre-excitation as a possible diagnosis, rather than bias towards a single alternative arrhythmia. The use of intravenous verapamil was associated with deterioration in the clinical condition of 6 patients and continued arrhythmia in all 10.
authors.affiliation: Department of Cardiological Sciences, St George's Hospital Medical School, London.
authors.forename: C
authors.initials: C
authors.lastname: Garratt
authors.forename: A
authors.initials: A
authors.lastname: Antoniou
authors.forename: D
authors.initials: D
authors.lastname: Ward
authors.forename: A J
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D003951:Diagnostic Errors; D004630:Emergencies; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D007275:Injections, Intravenous; D008508:Medication Errors; D008875:Middle Aged; D012189:Retrospective Studies; D013610:Tachycardia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014700:Verapamil / Q000008:administration & dosage / Q000009:adverse effects*; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D014700:Verapamil