[Verapamil in the cardioversion of atrial fibrillation. Clinical study].
BACKGROUND
Prolonged periods of atrial fibrillation (AF) or high frequency atrial pacing lead to a significant shortening of atrial refractory periods. This time-dependent electric remodelling is reduced significantly by the administration of verapamil.


METHODS
The present series consists of 24 patients all suffering from atrial fibrillation (33% acute AF and 66% chronic recurrent AF) admitted to our Cardiology Department (Rome University). Group G1 (13 patients) received i.v. verapamil (50 mg in 500 cc saline solution at 40 ml/hr). Group G2 (11 patients) received amiodarone i.v. (300 mg in bolus form followed by the infusion of 900 mg in 500 cc 5% glucosate solution, 33 ml/hr for 6 hours and subsequently 18 ml/hr). All patients received non-fractionated heparin i.v. at the same time.


RESULTS
No statistically significant difference was observed in the percentage of pharmacological cardioversions in the two groups: G1=61% vs G2=54% p=0.94). The patients who were not cardioverted pharmacologically were done so electrically (external DC shock).


CONCLUSIONS
Albeit in this small population of patients verapamil proved to possess anti-arrhythmic effects on a par with that of standard amiodarone antiarrhythmic treatment. This antiarrhythmic potential of verapamil should be demonstrated in a broader randomised study.
Martinelli
M M
MM
Prima Cardiologia, Università degli Studi di Roma, La Sapienza, Rome, Italy. margheritamartinelli@libero.it
Dragagna
G
G
Vitali
A
A
Fedele
F
F
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000628:therapy*; D004554:Electric Countershock / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D012032:Refractory Period, Electrophysiological / Q000502:physiology; D014700:Verapamil / Q000627:therapeutic use*
D000889:Anti-Arrhythmia Agents; D014700:Verapamil