Verapamil in the Treatment of Atrial Tachycardia with Block

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Abstract
Atrial tachycardia (A-T) with block is easily converted as a rule to sinus rhythm by DC [direct current] shock, but the recurrence rate is high. So far drug treatment of this arrhythmia was unsatisfactory. There is no drug of choice in the treatment of A-T with block. The effect of verapamil is reported on this arrhythmia in 14 patients. Ten of them reverted to sinus rhythm, but A-T with block later recurred in 4. The best effect was found in patients with no or only minimal heart enlargement and in patients with short duration of the arrhythmia. The effect of verapamil on A-T with block may support the concept of this arrhythmia being due to atrioventricular (A-V) nodal reentry, as the main effect of verapamil is a prolongation of the effective refractory period of the A-V node.