Effects of Intravenous Diltiazem on Sinus Node Function and Atrioventricular Conduction in Patients

Publisher Website
Google Scholar
Abstract
We studied the electrophysiologic effects of injectable diltiazem (dosage: bolus of 0.15 mg/kg, maintenance infusion of 0.3 mg/kg/h for 20 min) on sinus node function and atrioventricular function in 33 patients (22 men and 11 women, mean age 63.6 ± 15.8 years). Seventeen patients had an electrophysiological exploration considered as normal, eight had sinus node dysfunction (corrected sinus recovery time > 525 ms), and eight had AV nodal block (PH > 160 ms and/or a Wenckebach point < 125/min). Effects of the drug were assessed 20 min after the beginning of the infusion, which was continued until the end of examination. In normal subjects diltiazem lengthened corrected sinus node recovery time (305 ± 115 ms → 451 ± 283 ms) and slightly depressed AV nodal conduction (Wenckebach point: 163 ± 23 → 147 ± 25). In patients with sinus node dysfunction diltiazem provoked a bradycardia without significant changes in corrected sinus node recovery time or in estimated atrio-sino-atrial conduction time. In patients with AV nodal block diltiazem provoked a lowering of the Wenckebach point (137 ± 47 → 122 ± 38). There was no effect on hissian or infrahissian conduction, even when this was abnormal in the basal state. These data suggest that diltiazem must be utilized with caution in patients with sinus node dysfunction and AV nodal block.

This publication has 0 references indexed in Scilit: