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European Heart Journal 1985 6(6):525-531;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Effect of i.v. and oral tiapamil in the treatment of paroxysmal supraventricular tachycardia

J.P. FAUCHIER, F. ELKIK*, P. COSNAY, Ph, ROUESNEL, C. NEEL and L. QUILLET

*Research Department Roche, Neuilly-Sur-Seine, France
B Ward of Cardiology, Trousseau Hospital 37044 Tours Cédex, France

Received 30 July 1984; revised 15 February 1985; .

J. P. Fauchier, MD, B Ward of Cardiology, Trousseau Hospital, 37044 Tours cédex,France. Téléphone (47) 66.15.15 extension 53.81.

Abstract

Eleven patients, with recurrent paroxysmal supraventricular tachycardias (PSVT) underwentprogrammed electrical stimulation of the heart to evaluate the efficacy of intravenous (i.v.) and oral tiapamil in these arrhythmias. The tachycardia circuit was confined to the atrio-ventricular (AV) node in 8 cases (group 1), and involved an overt or concealed accessory pathway for retrograde conduction in the 3 others (group 2). An i.v. bolus containing 2 mg kg-l body weight of tiapamil converted 6 of the 8 cases in group1 from PSVT to normal sinus rhythm (NSR) within a few seconds, but failed to do so in anyof the three patients in group 2. Both the oral and i.v. preparations significantly lengthened the shortest cycle length maintaining 1:1 AV conduction. i.v. administration also lengthened the corresponding value for 1:1 VA retrograde conduction. The oral and i.v. preparations were equally effective in preventing induction of PSVT in 6/8 patients in group 1, but failed in group 2. The efficacy of oral tiapamil in preventing such inductionwas also accurately predicted from the effect of the i.v. tiapamil on conversion to NSR. After the first week, the six successfully treated patients continued taking 1.2 to 1.5 gday–1 tiapamil for 9.7 ± 4 months. Complete suppression of their symptoms was observed in 5 cases.

Key Words: calcium entry blocker • arrhythmia • supraventricular tachycardia


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