1. Effects of verapamil and metoprolol on recovery from atrial electrical remodeling after cardioversion of long-lasting atrial fibrillation.
- Author
-
Bertaglia E, D'Este D, Zerbo F, Michieletto M, and Pascotto P
- Subjects
- Aged, Analysis of Variance, Atrial Fibrillation diagnosis, Atrial Fibrillation therapy, Atrial Function physiology, Echocardiography, Doppler, Electrophysiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Probability, Prospective Studies, Risk Assessment, Severity of Illness Index, Treatment Outcome, Ventricular Remodeling drug effects, Atrial Fibrillation drug therapy, Atrial Function drug effects, Calcium Channel Blockers administration & dosage, Electric Countershock methods, Metoprolol administration & dosage, Verapamil administration & dosage
- Abstract
The aim of this prospective, randomized study was to investigate the effect of pretreatment with two different intracellular calcium-lowering drugs (verapamil and metoprolol) on recovery from atrial effective refractory period (AERP) shortening after internal electrical cardioversion (EC) of persistent atrial fibrillation (AF) in patients on amiodarone. Twenty-one patients on amiodarone for at least 30 days were referred to our hospital for internal EC of a persistent AF refractory to external EC. They were randomized to receive only amiodarone (group AMI, n=7), or amiodarone and verapamil 240 mg/day (group VER, n=7), or amiodarone and metoprolol 100 mg/day (group MET, n=7). Left AERP was measured 10 min and 24 h after EC. AERP was also determined in 13 controls. The AERP after 10 min was significantly shorter in group AMI (201 (31) ms, P<0.02) and group MET (203 (34) ms, P<0.03) than in controls (249 (45) ms), but not in group VER (237 (51) ms, P=NS). The AERP after 24 h was still significantly shorter in group AMI (204 (38) ms, P<0.04) than in controls, but not in group MET (225 (52) ms, P=NS) or in group VER (290 (36) ms, P=NS). Pretreatment with amiodarone and verapamil prevents AERP shortening, while pretreatment with amiodarone and metoprolol only accelerated AERP recovery.
- Published
- 2003
- Full Text
- View/download PDF