Verapamil in atrial fibrillation and atrial flutter

Area of Science:

• Cardiology
• Pharmacology

Background:

• Atrial fibrillation and atrial flutter are common arrhythmias characterized by rapid ventricular rates.
• Effective management of these conditions is crucial for preventing complications such as heart failure and stroke.

Purpose of the Study:

• To compare the efficacy of intravenous verapamil versus saline in patients experiencing rapid ventricular rates due to atrial fibrillation or atrial flutter.
• To assess verapamil's impact on ventricular rate control and conversion to sinus rhythm.

Main Methods:

• A double-blind, randomized study involving 28 patients with rapid ventricular rate and either atrial fibrillation or atrial flutter.
• Patients received either intravenous verapamil or saline.
• Efficacy was measured by the change in ventricular rate and the occurrence of conversion to sinus rhythm.

Main Results:

• Verapamil significantly slowed ventricular rates in atrial fibrillation (85-95%) compared to saline (14%) (p < 0.001).
• Verapamil led to conversion to sinus rhythm in 15% of atrial fibrillation patients, versus 0% with saline.
• For atrial flutter, verapamil slowed ventricular rates in 57-100% of patients, compared to 0% with saline (p < 0.001), and achieved sinus rhythm in 14%.

Conclusions:

• Intravenous verapamil is an effective treatment for controlling rapid ventricular rates in atrial fibrillation and atrial flutter.
• Verapamil demonstrates a statistically significant benefit over saline in both rate control and rhythm conversion for these arrhythmias.