title: Usefulness of diltiazem in the acute management of supraventricular tachyarrhythmias in the elderly.
abstract: Acute management of supraventricular tachyarrhythmias is often difficult in elderly patients. Diltiazem was given intravenously (loading dose of 0.25 mg/kg over 2 minutes followed by a 4 mg/kg/24 hr infusion) in 37 elderly patients (mean age 70 years, range 60-91). Fifteen out of the 37 patients (41%) had left ventricular cardiac disease, 12 (32%) had cor pulmonale, and 10 (27%) had no obvious cardiac disease. Hemodynamic tolerance of the supraventricular tachyarrhythmia was poor in 12 patients. A good result was defined as a return to sinus rhythm after bolus or infusion, or as a slowing of the ventricular rate (VR) to less than 100 beats/min. Of the 23 patients in atrial fibrillation, about half reverted to sinus rhythm after diltiazem, and in most of the others the ventricular rate decreased to less than 100 beats/min. Side effects occurred in 10 patients (bradycardia in 6, cutaneous rash in 2, hypotension in 2). They rapidly reversed after cessation of diltiazem. They were responsible for 2 out of the 5 poor results. Thus, diltiazem appeared effective and safe when used carefully in elderly patients with supraventricular tachyarrhythmia.
authors.affiliation: Division of Cardiology, University Hospital, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Millaire
authors.forename: O
authors.initials: O
authors.lastname: Leroy
authors.forename: P
authors.initials: P
authors.lastname: de Groote
authors.forename: C
authors.initials: C
authors.lastname: Santré
authors.forename: G
authors.initials: G
authors.lastname: Ducloux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects; D004110:Diltiazem / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D004110:Diltiazem