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Electrophysiologic effects of intravenous verapamil in children after operations for congenital heart disease


American Journal of Cardiology 60(8): 692-696
Electrophysiologic effects of intravenous verapamil in children after operations for congenital heart disease
To assess the effect of verapamil in children with congenital heart disease after surgical correction, an electrophysiologic study was undertaken in 19 patients, 0.8 to 15 years old. Atrial pacing and programmed atrial extrastimulation were performed before and 5 mm after intravenous administration of verapamil. A significant increase in conduction time and refractory periods was observed at the atrioventricular node level. Dual or accessory atrioventricular pathways, present in 14 cases, appear to have been suppressed in 9. The effect on the sinus node was of particular interest: The corrected sinus node recovery time was strongly prolonged by verapamil in 6 patients, 5 of whom had undergone surgery with extensive atrial reconstruction (Senning 2, anomalous pulmonary venous return 3) and 1 of whom had undergone correction of tetralogy of Fallot. Additional effects of verapamil were the disappearance of a sinus node entrance block in 8 patients and emergence of an ectopic pacemaker in 6. Although verapamil has electrophysiologic properties that should make it a useful drug in the treatment of reentry tacthycardia, caution is indicated after extensive atrial surgery because sinus node depression may occur.

Accession: 005349308

PMID: 3661437

DOI: 10.1016/0002-9149(87)90384-5

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