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European Heart Journal 1988 9(5):471-478;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Effect of nifedipine on arrhythmias in the acute phase of myocardial infarction

L. J. E. WALKER, G. MACKENZIE and A. A. J. ADGEY

Regional Medical Cardiology Centre and Department of Community Medicine, Royal Victoria Hospital and Queen's University Belfast, U.K

Received 21 August 1987; revised 19 October 1987; .

Address for correspondence: A. A. J. Adgey, MD, FRCP, FRCPI, FACC, Consultant Cardiologist, Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast BT12 6BA, U.K.

Abstract

In a double-blind placebo-controlled trial to study the effect of nifedipine on ventricular arrhythmias among patients with acute myocardial infarction, 434 patients with suspected myocardial infarction were randomized within 6 h from the onset of chest pain to treatment with nifedipine (p = 217) or placebo (p = 217). During the 48-h treatment period/a 10-mg capsule containing active drug or placebo was administered sublingually every 4 hfor 24 h, then orally every 4-h for the next 24 h. Acute myocardial infarction was confirmed in 295 patients (146 in the nifedipine group and 149 in the placebo group). Twenty-four hour ECG tape analysis during 1–5 h from onset of chest pain shawed that there was no significant difference in the number of patients with ventricular ectopics, ventriculars couplets, ventricular tachycardia (3–9 beat's), self terminating or sustained ventricular tachycardia between the two treatment groups. Also during the > 5–24 h from onset of chest pain, the numbers of patients with ventricular coupius, multifocal, bigeminalor couplets, self-terminating ventricular tachycardia or sustained ventricular baclfycardia did not differ significantly. However, there was a significant reduction in the number of patients with short runs of ventricular tachycardia (3–9 beats) in the nifedipine-treated group. There was no significant difference among patients with ventricular fibrillation between the two treatment groups.

Key Words: Nifedipine • arrhythmias • acute myocardial infarction


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