Effect of Verapamil on Retrograde Ventriculo-Atrial Conduction in Children

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Abstract
The effects of verapamil, a slow channel blocker and a potent antiarrhythmic drug, on retrograde V-A [ventriculo-atrial] conduction were investigated following diagnostic cardiac catheterization in 12 children premedicated with lytic cocktail. Surface ECG, intra-atrial and His bundle electrograms and right ventricular pacing using an extra stimulus technique were obtained before and after a single i.v. dose of verapamil (0.15 mg/kg maximum 5 mg). Verapamil prolonged the AH [atrio-hisial] interval in 9/12 and abolished or prolonged the retrograde V-A conduction whenever present (abolition in 5/12 and prlongation in 1/12). The duration of retrograde V-A conduction exceeded the antegrade conduction time in all. Verapamil abolishes retrograde V-A conduction whenever present, and this phenomenon may explain the antiarrhythmic effects of the drug on retrograde conduction dependent (reentrant) arrhythmias.

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