Effects of verapamil on anterior ST segment and ventricular fibrillation cycle length in patients with Brugada syndrome

J Electrocardiol. 2009 Jul-Aug;42(4):367-73. doi: 10.1016/j.jelectrocard.2009.03.009. Epub 2009 Apr 7.

Abstract

Purpose: This study examined the effects of verapamil (5-10 mg intravenous) on the cardiac electrical activity of 10 Brugada syndrome (BS) patients having vasospastic angina, atrial fibrillation, and/or hypertension.

Results: Verapamil showed no significant change in the ST-segment elevation. Likewise, there was no significant change in the lengths of QRS complex, HV and corrected QT intervals, or effective refractory period at the right ventricle. The conduction time between right ventricular apex and outflow tract, measured at 400-millisecond pacing, was mildly prolonged by verapamil. At baseline, induced ventricular fibrillation (VF) was terminated by a 200-J shock in all patients. After verapamil, VF was reinduced in 7, was noninducible in 2, and self-terminated in 1 patient. Mean F-F interval was shorter after than before verapamil, and a 360-J shock was required in 2 of the 7 patients.

Conclusion: In some BS patients, calcium channel blockade may modify the electrical characteristics of VF.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Anti-Arrhythmia Agents / administration & dosage
  • Brugada Syndrome / diagnosis
  • Brugada Syndrome / drug therapy*
  • Brugada Syndrome / physiopathology*
  • Electrocardiography / drug effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / drug therapy*
  • Ventricular Fibrillation / physiopathology*
  • Verapamil / administration & dosage*

Substances

  • Anti-Arrhythmia Agents
  • Verapamil