title: Preliminary investigation of the efficacy of sublingual verapamil in the management of acute atrial fibrillation and flutter.
abstract: The antiarrhythmic properties of sublingual verapamil were investigated in seven patients with acute fast atrial flutter (n = 2) or fibrillation (n = 5). A rapid and significant (P < 0.05) reduction in the ventricular rate was achieved in all seven patients. The ventricular rate at peak plasma verapamil concentration (+/- s.d.) was significantly slower than on admission (101.6 +/- 11.3 and 159 +/- 5.3 beats min-1 respectively, P < 0.01). The ventricular rate remained controlled for over 4 h. Sublingual verapamil was rapidly absorbed with the maximum peak plasma concentration (153.3 +/- 15.5 ng ml-1) being achieved after 1.21 +/- 0.18 h. Side-effects of sublingual verapamil were limited to one report of a bitter taste. The sublingual administration of verapamil may provide an alternative method for the control of acute fast atrial fibrillation and flutter in selected patients.
authors.affiliation: Cardiology Department, Western General Hospital, Edinburgh.
authors.forename: S
authors.initials: S
authors.lastname: Fort
authors.forename: M J
authors.initials: MJ
authors.lastname: Lewis
authors.forename: D K
authors.initials: DK
authors.lastname: Luscombe
authors.forename: D N
authors.initials: DN
authors.lastname: John
mesh_terms: D000208:Acute Disease; D000286:Administration, Sublingual; D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001282:Atrial Flutter / Q000188:drug therapy*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D014700:Verapamil / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics
chemical_list: C016904:norverapamil; D014700:Verapamil