[Prevention of effort-induced ventricular arrhythmia using verapamil].
In this study prophylactic antiarrhythmic effects of verapamil on exercise-induced ventricular arrhythmias were evaluated in a total of 22 patients. All patients displayed frequent and/or complex ventricular arrhythmias during repeated exercise tests under control conditions. After two control exercise tests, all patients were treated with 120 mg verapamil given every 8 h orally for 4 days. On the 3rd and 4th day of treatment the exercise tests were repeated. The results were that verapamil caused a significant reduction in the incidence and severity of exercise-induced ventricular arrhythmias in 13 out of 22 patients. In patients with concomitant significant ST-segment depression, a prophylactic action could be demonstrated in nine out of ten cases. The antiarrhythmic effect was independent of changes in heart rate. In patients with myocardial ischaemia, a reduction in myocardial oxygen consumption and direct electrophysiological effects (suppression of the "slow response" and/or an increase in the resting potential of the "depressed fast response") can be discussed as mechanisms of action. Also, a suppression of "triggered activity" or a direct inhibition of adrenergic effects must be considered. According to our results and the literature, calcium antagonists (verapamil type) proved to be suitable drugs for the treatment of exercise-induced ventricular arrhythmias, particularly in patients with concomitant myocardial ischaemia.
Gülker
H
H
Medizinische Klinik und Poliklinik (Abteilung Innere Medizin C), Westfälische Wilhelms-Universität Münster.
Godejohann
U
U
Dorsel
T
T
Behrenbeck
T
T
Heuer
H
H
Bender
F
F
D001145:Arrhythmias, Cardiac / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D014700:Verapamil / Q000627:therapeutic use*
D014700:Verapamil
Prophylaxe belastungsinduzierter ventrikulärer Arrhythmien durch Verapamil.