Abstract:
:Although digoxin is often the first choice for control of ventricular response in chronic atrial fibrillation, it fails to slow exercise rates. Diltiazem, a calcium channel antagonist that slows atrioventricular conduction, was administered to 16 patients who failed to achieve adequate rate control on low level exercise testing despite digoxin therapy. Therapeutic response to diltiazem was assessed with submaximal and maximal exercise tests and 24 hour ambulatory electrocardiographic monitoring. During the diltiazem treatment phase, ventricular response at rest diminished (96 +/- 17 versus 69 +/- 10 beats/min, p less than 0.001) as did rate during submaximal exercise (155 +/- 28 versus 116 +/- 26, p less than 0.001), maximal exercise (163 +/- 14 versus 133 +/- 26, p less than 0.001) and average ventricular response during 24 hour monitoring (87 +/- 13 versus 69 +/- 10, p less than 0.001). Rate at rest decreased 26 +/- 15% and submaximal exercise rate diminished 24 +/- 12%. Thirteen (81%) of the 16 patients exhibited at least 15% slowing of rate at rest and during submaximal exercise. Eleven patients (69%) reported alleviation of symptoms. There was no change in serum digoxin levels during diltiazem treatment (1.3 +/- 0.5 versus 1.3 +/- 0.6 ng/ml, p = NS). On withdrawal of diltiazem, ventricular response returned to baseline values. Diltiazem is an effective agent for control of ventricular response, both at rest and during exercise, in digoxin-treated patients with chronic atrial fibrillation.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Steinberg JS,Katz RJ,Bren GB,Buff LA,Varghese PJdoi
10.1016/s0735-1097(87)80396-0subject
Has Abstractpub_date
1987-02-01 00:00:00pages
405-11issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(87)80396-0journal_volume
9pub_type
杂志文章abstract:OBJECTIVES:We sought to study the role of I(KACh) in atrial fibrillation (AF) and the potential electrophysiologic effects of a specific I(KACh) antagonist. BACKGROUND:I(KACh) mediates much of the cardiac responses to vagal stimulation. Vagal stimulation predisposes to AF, but the specific role of I(KACh) in the gener...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01304-3
更新日期:2001-06-15 00:00:00
abstract::Drug-induced long QT syndrome (diLQTS) and congenital LQTS (cLQTS) share many features, and both syndromes can result in life-threatening torsades de pointes (TdP). Our understanding of their mechanistic and genetic similarities has led to their improved clinical management. However, our inability to prevent diLQTS ha...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2016-04-05 00:00:00
abstract:OBJECTIVES:We compared the safety of different devices by screening for subclinical intracranial embolic events after pulmonary vein isolation with either conventional irrigated radiofrequency (RF) or cryoballoon or multielectrode phased RF pulmonary vein ablation catheter (PVAC). BACKGROUND:New devices specifically d...
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doi:10.1016/j.jacc.2011.04.010
更新日期:2011-08-09 00:00:00
abstract:OBJECTIVES:This study was undertaken to elucidate the prevalence of aortic valve abnormalities in the elderly. BACKGROUND:The age of persons treated actively for valve disorders is increasing. More information is needed about the prevalence of aortic valve disease in old age. METHODS:Randomly selected men and women i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90249-z
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abstract::Development or progression of left ventricular hypertrophy has recently been described in children with hypertrophic cardiomyopathy. To determine whether similar changes in magnitude and distribution of left ventricular hypertrophy may also occur in adult patients with this disease, serial assessment of left ventricul...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80301-7
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVES:This study investigated the effect of age and gender on central arterial hemodynamic variables derived from noninvasive tonometric carotid pressure waveforms. BACKGROUND:Women have a greater age-related increase in left ventricular (LV) mass than do men and are more likely to experience symptomatic heart fa...
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doi:10.1016/j.jacc.2016.03.543
更新日期:2016-05-24 00:00:00
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doi:10.1016/j.jacc.2016.07.735
更新日期:2016-10-04 00:00:00
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doi:10.1016/s0735-1097(02)02937-6
更新日期:2003-03-05 00:00:00
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pub_type: 杂志文章
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更新日期:1989-12-01 00:00:00
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更新日期:1998-10-01 00:00:00
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更新日期:2007-02-13 00:00:00
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pub_type: 杂志文章
doi:10.1016/0735-1097(96)00126-x
更新日期:1996-07-01 00:00:00
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更新日期:1994-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 指南,杂志文章
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更新日期:1991-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0735-1097(92)90201-w
更新日期:1992-10-01 00:00:00
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更新日期:2001-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1992-03-01 00:00:00
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更新日期:2005-07-19 00:00:00
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更新日期:2015-08-04 00:00:00
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更新日期:2009-04-14 00:00:00
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pub_type: 杂志文章
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更新日期:1995-09-01 00:00:00
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更新日期:2007-05-01 00:00:00
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更新日期:2020-06-23 00:00:00
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更新日期:2002-12-18 00:00:00
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更新日期:1985-10-01 00:00:00
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doi:10.1016/0735-1097(93)90362-5
更新日期:1993-03-15 00:00:00
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更新日期:1997-07-01 00:00:00
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更新日期:1988-01-01 00:00:00
abstract::Seventeen patients (16 men and 1 woman) were challenged with isoproterenol after their initially inducible sustained ventricular tachyarrhythmia (monomorphic tachycardia in 14 patients and fibrillation in 3) was completely suppressed by class I antiarrhythmic drugs. Coronary artery disease was documented in 11 patient...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90114-9
更新日期:1989-09-01 00:00:00