Acute conversion of paroxysmal supraventricular tachycardia with intravenous diltiazem

Anne Hamilton Dougherty, Warren M. Jackman, Gerald V. Naccarelli, Karen J. Friday, Virgil C. Dias

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Diltiazem has electrophysiologic effects similar to those of verapamil. Its efficacy and safety in 4 doses for treatment of induced supraventricular tachycardia (SVT) were examined and compared with those of placebo in 87 patients (25 with atrioventricular [AV] nodal reentry tachycardia, 60 with AV reentry associated with an accessory AV connection, and 2 with atrial tachycardia). Conversion to sinus rhythm occurred in 4 of 14 patients (29%) with 0.05 mg/kg of diltiazem, 16 of 19 (84%) with 0.15 mg/kg, 13 of 13 (100%) with 0.25 mg/kg, and 14 of 17 (82%) with 0.45 mg/kg compared with 6 of 24 (25%) treated with placebo. Conversion rates in groups receiving doses of 0.15 to 0.45 mg/kg of diltiazem were superior to that in the placebo group (p < 0.001). Time to conversion was 3.0 ± 2.6 minutes in responding diltiazem patients compared with 5.9 ± 6.1 minutes in responding control patients. Diltiazem administration resulted in significant lengthening of SVT cycle length, AH interval, and AV nodal effective refractory period and block cycle length. The most frequent adverse response to diltiazem was hypotension (7 of 63 patients); however, only 4 patients had symptoms related to hypotension. Thus, intravenous diltiazem in doses of 0.15, 0.25 and 0.45 mg/kg is an effective and safe treatment for the acute management of SVT.

Original languageEnglish (US)
Pages (from-to)587-592
Number of pages6
JournalThe American journal of cardiology
Volume70
Issue number6
DOIs
StatePublished - Sep 1 1992

Fingerprint

Paroxysmal Tachycardia
Supraventricular Tachycardia
Diltiazem
Placebos
Hypotension
Atrioventricular Nodal Reentry Tachycardia
Verapamil
Tachycardia
Safety
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Dougherty, Anne Hamilton ; Jackman, Warren M. ; Naccarelli, Gerald V. ; Friday, Karen J. ; Dias, Virgil C. / Acute conversion of paroxysmal supraventricular tachycardia with intravenous diltiazem. In: The American journal of cardiology. 1992 ; Vol. 70, No. 6. pp. 587-592.
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abstract = "Diltiazem has electrophysiologic effects similar to those of verapamil. Its efficacy and safety in 4 doses for treatment of induced supraventricular tachycardia (SVT) were examined and compared with those of placebo in 87 patients (25 with atrioventricular [AV] nodal reentry tachycardia, 60 with AV reentry associated with an accessory AV connection, and 2 with atrial tachycardia). Conversion to sinus rhythm occurred in 4 of 14 patients (29{\%}) with 0.05 mg/kg of diltiazem, 16 of 19 (84{\%}) with 0.15 mg/kg, 13 of 13 (100{\%}) with 0.25 mg/kg, and 14 of 17 (82{\%}) with 0.45 mg/kg compared with 6 of 24 (25{\%}) treated with placebo. Conversion rates in groups receiving doses of 0.15 to 0.45 mg/kg of diltiazem were superior to that in the placebo group (p < 0.001). Time to conversion was 3.0 ± 2.6 minutes in responding diltiazem patients compared with 5.9 ± 6.1 minutes in responding control patients. Diltiazem administration resulted in significant lengthening of SVT cycle length, AH interval, and AV nodal effective refractory period and block cycle length. The most frequent adverse response to diltiazem was hypotension (7 of 63 patients); however, only 4 patients had symptoms related to hypotension. Thus, intravenous diltiazem in doses of 0.15, 0.25 and 0.45 mg/kg is an effective and safe treatment for the acute management of SVT.",
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Acute conversion of paroxysmal supraventricular tachycardia with intravenous diltiazem. / Dougherty, Anne Hamilton; Jackman, Warren M.; Naccarelli, Gerald V.; Friday, Karen J.; Dias, Virgil C.

In: The American journal of cardiology, Vol. 70, No. 6, 01.09.1992, p. 587-592.

Research output: Contribution to journalArticle

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