title: Effect of verapamil on immediate recurrence of atrial fibrillation.
abstract: BACKGROUND
  The purpose of this study was to assess the effect of verapamil on immediate recurrences of atrial fibrillation occurring after successful electrical cardioversion.
  
  
  RESULTS
  The effect of verapamil on the recurrence of atrial fibrillation within 5 minutes after successful transthoracic cardioversion was assessed in 19 (5%) of 364 patients undergoing electrical cardioversion. The mean duration of atrial fibrillation was 4.44+/-3.0 months. In the 19 patients, cardioversion was successful after each of three consecutive cardioversion attempts per patient; however, atrial fibrillation recurred 0.4+/-0.3 minutes after cardioversion. Verapamil 10 mg was administered intravenously and a fourth cardioversion was performed. Cardioversion after verapamil was successful in each patient, and atrial fibrillation did not recur in 9 (47%) of 19 patients (P < 0.001 vs before verapamil). In the remaining 10 patients in whom atrial fibrillation recurred, the duration of sinus rhythm was significantly longer compared with before verapamil (3.6+/-2.4 min, P < 0.001). The density of atrial ectopy occurring after cardioversion was significantly less after verapamil (21+/-14 ectopic beats per min) compared with before verapamil (123+/-52 ectopic beats per min, P < 0.001).
  
  
  CONCLUSIONS
  Among patients with immediate recurrence of atrial fibrillation after electrical cardioversion, acute calcium channel blockade by verapamil reduces recurrence of atrial fibrillation and extends the duration of sinus rhythm.
authors.affiliation: Mid-Ohio Cardiology, Riverside-Methodist Hospital, Columbus, USA. egd@mocc.cc
authors.forename: E G
authors.initials: EG
authors.lastname: Daoud
authors.forename: J D
authors.initials: JD
authors.lastname: Hummel
authors.forename: R
authors.initials: R
authors.lastname: Augostini
authors.forename: S
authors.initials: S
authors.lastname: Williams
authors.forename: S J
authors.initials: SJ
authors.lastname: Kalbfleisch
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004554:Electric Countershock; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013997:Time Factors; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002121:Calcium Channel Blockers; D014700:Verapamil