Supraventricular tachycardias are commonly encountered arrhyhthmias. In this study, the effectiveness of digitalis and verapamil were investigated in recent onset (before two weeks) supraventricular tachycardias. (atrial fibrillation, flutter and paroxysmal atrial tachycardia)
Eighty patients with supraventricular tachycardias were enrolled to the study and were divided into two groups. There were 22 female and 18 male patients in each group.The mean ages were 61 ±8,6 years in verapamil group and 59±9,6 years in digitalis group. At the begining, the means of heart rates were 159,8±9,2 bpm in first group and 163,3±7,9 bpm in second group. There was no significant difference between the two groups in terms of age, sex, heart rates (p>0,0).Digitalis 0,5 mg and verapamil 5 mg were applied to the patients for five minutes intravenously. At the end of one hour, same dosages of these drugs were given to the patients whose rhythm did not convert to sinus rhythm.
After 15 minutes, the heart rates of the patients of two groups started to decrease significantly (p0,05 ). Verapamil achieved to conversion to sinus rhythm in 21,05% of the patients with atrial fibrillation, 25% of these with atrial flutter 53,8 % of these with paroxysmal atrial tachycardia. In the patients treated with digitalis , these rates were in turn 44,4 %, 25% and 42,8% . These rates were not different between two groups (p>0,05). Six patients (%22,2) treated with verapamil with paroxysmal atrial tachycardia whose ventricular rates had not been controlled and hemodynamic status had been deteriorated (ventricular rate above 160 bpm, systolic tension below 90 mmHg, schock) were converted to sinus rhythm after electrical cardioversion. Ventricular rates were reduced with amiodarone in four patients and with verapamil in three patients who had not responsed to digitalis in total 7 patients (%50) with paroxysmal atrial tachycardia.
Verapamil and digitalis were moderately effective for conversion to sinus rhythm and very effective antiarrhythmic drugs for reduction of ventricular rate in supraventricular tachycardias. Electrical cardioversion is the most effective method in patients with hypotension and high ventricular rates.
Key words: Supraventricular tachycardias, Digitalis, Verapamil
|
