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Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion.
De Simone, A; Stabile, G; Vitale, D F; Turco, P; Di Stasio, M; Petrazzuoli, F; Gasparini, M; De Matteis, C; Rotunno, R; Di Napoli, T.
Afiliação
  • De Simone A; Laboratorio di Elettrofisiologia, Casa di Cura San Michele, Maddaloni, Italy.
J Am Coll Cardiol ; 34(3): 810-4, 1999 Sep.
Article em En | MEDLINE | ID: mdl-10483964
OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7%) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p < 0.05). Significantly, 15 (65.2%) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3%) than group II (2/34 patients, 5.9%; p = 0.01) and group III (3/30 patients, 10%; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pré-Medicação / Fibrilação Atrial / Cardioversão Elétrica / Verapamil / Antiarrítmicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 1999 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pré-Medicação / Fibrilação Atrial / Cardioversão Elétrica / Verapamil / Antiarrítmicos Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 1999 Tipo de documento: Article