Supraventricular tachyarrthmias efficacy of verapamil

ABSTRACT

verapamil is the drug most widely used in the management of supraventricular tachyarrhythias [SVT] in the absence of contraindications. Hypotention complicating SVT is not considered an absolute contraindication for the use of IV verapamil. The purpose of this study was to assess the efficacy of IV Verapamil in SVT. And its safety in the patients with arterial hypotension. The study was retrospective conducted in Salmaniya Medical Center, Accident and Emergency Department. Inclusion criteria were SVT [defined as narrow complex tachycardia with regular R.R. interval and rate of 150 BPM or more, systolic blood pressure between 90 and 150mm/Hg. 60 consecutive cases were included, age range 27-70 years, female male = 46 14 i.e. ration 3 1. all patients with organic heart diseases, heart failure, thyroid disease or ECG abnormality rather than SVT. Were excluded from the study. Verapamil was administered in 58 patients. One patient converted spontaneously to NSR before treatment and one patient reverted with carotid massage. Carotid massage was tried as first line therapy in only 2 patients. Three patients did not respond to verapamil but reverted following digoxin IV efficacy of verapamil was 94.8% [55/58]. Hypotension following verapamil was not encountered in any patient. Hematological investigations were done in 59 patients [98.3%] and chest radiographs were done in 59 patients [98.3%]. These had no influence on the management and so were deemed unnecessary. 12 patients [20%] were admitted to rule out ischemic heart disease. The remaining was discharged from A/E within few hours