Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion

Antonio De Simone, Giuseppe Stabile, Dino Franco Vitale, Pietro Turco, Maurizio Di Stasio, Ferdinando Petrazzuoli, Maurizio Gasparini, Carmine De Matteis, Raffaele Rotunno, Tommaso Di Napoli

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7%) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p <0.05). Significantly, 15 (65.2%) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3%) than group II (2/34 patients, 5.9%; p = 0.01) and group III (3/30 patients, 10%; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.

Original languageEnglish
Pages (from-to)810-814
Number of pages5
JournalJournal of the American College of Cardiology
Volume34
Issue number3
DOIs
Publication statusPublished - Sep 1999

Fingerprint

Electric Countershock
Verapamil
Atrial Fibrillation
Recurrence
Atrial Remodeling
Propafenone
Incidence
Oral Administration
Calcium
Survival

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion. / De Simone, Antonio; Stabile, Giuseppe; Vitale, Dino Franco; Turco, Pietro; Di Stasio, Maurizio; Petrazzuoli, Ferdinando; Gasparini, Maurizio; De Matteis, Carmine; Rotunno, Raffaele; Di Napoli, Tommaso.

In: Journal of the American College of Cardiology, Vol. 34, No. 3, 09.1999, p. 810-814.

Research output: Contribution to journalArticle

De Simone, A, Stabile, G, Vitale, DF, Turco, P, Di Stasio, M, Petrazzuoli, F, Gasparini, M, De Matteis, C, Rotunno, R & Di Napoli, T 1999, 'Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion', Journal of the American College of Cardiology, vol. 34, no. 3, pp. 810-814. https://doi.org/10.1016/S0735-1097(99)00256-9
De Simone, Antonio ; Stabile, Giuseppe ; Vitale, Dino Franco ; Turco, Pietro ; Di Stasio, Maurizio ; Petrazzuoli, Ferdinando ; Gasparini, Maurizio ; De Matteis, Carmine ; Rotunno, Raffaele ; Di Napoli, Tommaso. / Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion. In: Journal of the American College of Cardiology. 1999 ; Vol. 34, No. 3. pp. 810-814.
@article{91fa20068baa402fa433097169ac629b,
title = "Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion",
abstract = "OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7{\%}) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p <0.05). Significantly, 15 (65.2{\%}) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3{\%}) than group II (2/34 patients, 5.9{\%}; p = 0.01) and group III (3/30 patients, 10{\%}; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.",
author = "{De Simone}, Antonio and Giuseppe Stabile and Vitale, {Dino Franco} and Pietro Turco and {Di Stasio}, Maurizio and Ferdinando Petrazzuoli and Maurizio Gasparini and {De Matteis}, Carmine and Raffaele Rotunno and {Di Napoli}, Tommaso",
year = "1999",
month = "9",
doi = "10.1016/S0735-1097(99)00256-9",
language = "English",
volume = "34",
pages = "810--814",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Pretreatment with verapamil in patients with persistent or chronic atrial fibrillation who underwent electrical cardioversion

AU - De Simone, Antonio

AU - Stabile, Giuseppe

AU - Vitale, Dino Franco

AU - Turco, Pietro

AU - Di Stasio, Maurizio

AU - Petrazzuoli, Ferdinando

AU - Gasparini, Maurizio

AU - De Matteis, Carmine

AU - Rotunno, Raffaele

AU - Di Napoli, Tommaso

PY - 1999/9

Y1 - 1999/9

N2 - OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7%) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p <0.05). Significantly, 15 (65.2%) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3%) than group II (2/34 patients, 5.9%; p = 0.01) and group III (3/30 patients, 10%; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.

AB - OBJECTIVES: To evaluate, in a prospective and randomized fashion, the efficacy of a pretreatment with verapamil (V) in reducing recurrences of atrial fibrillation (AF) after electrical cardioversion (C). BACKGROUND: The increased vulnerability for AF recurrence is probably due to AF-induced changes in the electrophysiologic properties of the atria. This electrical remodeling seems to be due to intracellular calcium overload. METHODS: One hundred seven patients with persistent or chronic AF underwent external and/or internal C. All patients received oral propafenone (P) (900 mg/day) three days before and during the entire period of follow-up (three months). In the first group, patients received only the P. In the second group, in adjunct to P, oral V (240 mg/day) was initiated three days before C and continued during the follow-up. Finally, in the third group, oral V was administered three days before and continued only for three days after electrical C. RESULTS: During the three months of follow-up, 23 patients (23.7%) had AF recurrence. Mantel-Haenszel cumulative chi-square reached a significant level only when comparing AF free survival curves of group I versus group II and group III (chi-square = 5.2 and 4, respectively; p <0.05). Significantly, 15 (65.2%) AF relapses occurred during the first week after cardioversion with a higher incidence in group I (10/33 patients, 30.3%) than group II (2/34 patients, 5.9%; p = 0.01) and group III (3/30 patients, 10%; p = 0.04). CONCLUSIONS: Six days of oral V administration centered on the C day, combined with P, significantly reduce the incidence of early recurrences of AF compared with P alone.

UR - http://www.scopus.com/inward/record.url?scp=0032835264&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032835264&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(99)00256-9

DO - 10.1016/S0735-1097(99)00256-9

M3 - Article

C2 - 10483964

AN - SCOPUS:0032835264

VL - 34

SP - 810

EP - 814

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 3

ER -