S H Lim1, V Anantharaman, W S Teo. 1. Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Abstract
OBJECTIVE: To compare the efficacy of verapamil and diltiazem as slow infusions in terminating spontaneous supraventricular tachycardia (SVT) in the emergency department (ED). METHOD:Patients of at least 10 years of age who presented to our ED with regular narrow complex tachycardia not converted with a vagal manoeuvre with an ECG diagnosis of SVT were included. Those who were haemodynamically unstable were excluded. Patients were randomized to undergo either verapamil infusion at a rate of 1 mg/min to a maximum of 20 mg or diltiazem infusion at a rate of 2.5 mg/min to a maximum of 50 mg. RESULTS:Eighty-one patients were randomized to receive verapamil infusion and 80 were randomized to receive the diltiazem infusion. There is no difference in success rate between verapamil (98.8%) and diltiazem (96.3%) infusion. The dose of medication required to convert 25,50 and 75% of SVTs were 4.0,5.0 and 8.0 mg for the verapamil infusion and 10.0,12.5 and 17.5 mg for the diltiazem infusion. There was one complication in each group. CONCLUSION:Calcium channel blockers infusions were safe and efficacious in terminating spontaneous SVT. There was no difference between the success rates of verapamil and diltiazem infusions.
RCT Entities:
OBJECTIVE: To compare the efficacy of verapamil and diltiazem as slow infusions in terminating spontaneous supraventricular tachycardia (SVT) in the emergency department (ED). METHOD:Patients of at least 10 years of age who presented to our ED with regular narrow complex tachycardia not converted with a vagal manoeuvre with an ECG diagnosis of SVT were included. Those who were haemodynamically unstable were excluded. Patients were randomized to undergo either verapamil infusion at a rate of 1 mg/min to a maximum of 20 mg or diltiazem infusion at a rate of 2.5 mg/min to a maximum of 50 mg. RESULTS: Eighty-one patients were randomized to receive verapamil infusion and 80 were randomized to receive the diltiazem infusion. There is no difference in success rate between verapamil (98.8%) and diltiazem (96.3%) infusion. The dose of medication required to convert 25,50 and 75% of SVTs were 4.0,5.0 and 8.0 mg for the verapamil infusion and 10.0,12.5 and 17.5 mg for the diltiazem infusion. There was one complication in each group. CONCLUSION: Calcium channel blockers infusions were safe and efficacious in terminating spontaneous SVT. There was no difference between the success rates of verapamil and diltiazem infusions.
Authors: Chi Keong Ching; Siew Hon Benjamin Leong; Siang Jin Terrance Chua; Swee Han Lim; Kenneth Heng; Sohil Pothiawala; Venkataraman Anantharaman Journal: Singapore Med J Date: 2017-07 Impact factor: 1.858
Authors: Halil Dogan; Dogac Niyazi Ozucelik; Kurtulus Aciksari; Ilker Murat Caglar; Nursel Okutan; Mustafa Yazicioglu; Baris Murat Avyaci; Cem Simsek; Derya Ozasir; Tufan Akin Giray; Cem Ayan; Feridun Celikmen; Yıldız Okuturlar; Sezgin Sarikaya Journal: Int J Clin Exp Med Date: 2015-06-15