A summary of the acute effects of falipamil in man

The verapamil analog falipamil is a new compound with specific bradycardic action on the sinus node. It differs from verapamil with respect to its electrophysiological and haemodynamic actions. Falipamil causes a slight prolongation of intraatrial and intraventricular conduction, whereas sinuatrial and AV-node conduction is enhanced. The refractory periods of atrial and ventricular myocardium and ventricular repolarization are significantly prolonged, whereas the refractory period of the AV-node is shortened. Falipamil fails to influence any haemodynamic parameter significantly at rest, if heart rate is kept constant. In exercise-induced myocardial ischaemia, changes in haemodynamics reflect changes in heart rate. Increased sinus rate at rest is significantly reduced by falipamil 15%-25%. Around 150 mg falipamil prove aequieffective to about 40 micrograms pindolol. Atropine-induced and catecholamine-induced sinus tachycardia is also significantly diminished. Increased sinus rate during exercise is lowered by about 10%. Through reduction of heart rate, falipamil proves capable of significantly diminishing or even preventing ischaemic ST-segment depression and ischaemia induced increase in pulmonary capillary pressure. Thus falipamil can be used to normalize sinus rate in patients with sinus tachycardia of various origin, particularly in intensive care, in acute ischaemic heart disease, in anaesthesia and in surgery cases.