Effect of Tiapamil in the Wolff-Parkinson-White Syndrome

Gmeiner, R; Ng, Choi Keung

doi:10.1097/00005344-198103000-00003

Cited by 12 publications

(6 citation statements)

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“…scsses electrophysiological effects similar to those of verapamil, provided that the dose employed is high enough [3]. An intravenous dose of 2 mg/kg tiapamil terminated circus movement tachycardias which involved the A-V node as an essential part of the reentry circuit [1,4]. The present report reviews our experience with intravenous tiapamil in a special subset of reciprocating tachycardias.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, we reported on the electrophysiological actions of tiapamil in normal subjects as well as in patients suffering from paroxysmal reentrant supraventricular tachy cardia with or without the Wolff-Parkinson- 1 Supported by a grant from the 'Fonds zur Förde rung der wissenschaftlichen Forschung in Österreich', project 4011.…”

Section: Introductionmentioning

confidence: 99%

“…White syndrome [1][2][3][4], The present paper reviews our experience with intravenous tia pamil in patients with concealed accessory pathways.…”

Section: Introductionmentioning

confidence: 99%

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Electrophysiology of Tiapamil in Concealed Accessory Pathways

Gmeiner¹,

Ng²

1982

Cardiology

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The effect of 2 mg/kg intravenous tiapamil was studied by programmed stimulation of the heart in 6 patients. Before tiapamil, sustained tachycardias were initiated in 5, and only atrial echoes in 1. In all patients, the reentrant circuit involved an accessory pathway conducting only in the ventriculoatrial direction. When administered during tachycardia, tiapamil promptly terminated the arrhythmia in 5 cases. Tiapamil lengthened the atrio-His (A-H) interval and the effective refractory period of the A-V node. As a result of these changes, it was not possible to initiate the tachycardia in 1 patient. In 1 case, tiapamil permitted the induction of sustained tachycardia, while only echoes had been initiated before the drug. In 2 cases, the tachycardia zone narrowed, in 2 others it widened following tiapamil. The ability to sustain the arrhythmia was lost in 1 patient. Tiapamil may be useful for the termination of reentrant supraventricular tachycardia involving concealed accessory pathways. Whether tiapamil prevents or favors the initiation of tachycardia in these patients depends on the interplay between the prolongation of the effective A-V nodal refractory period and the prolongation of the transnodal conduction time in individual patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Electrophysiology of Tiapamil in Concealed Accessory Pathways

Gmeiner¹,

Ng²

1982

Cardiology

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“…In previous studies, other investigators [1][2][3][4][5] as well as our group [6,7] have found tiapamil to be effective against several car diac arrhythmias. Although there have been many studies evaluating tiapamil and com paring its efficacy with that o f verapamil and lidocaine, to date there have been no studies comparing tiapamil and propranolol in the same patients.…”

Section: Introductionmentioning

confidence: 89%

Antiarrhythmic Effects of Tiapamil and Propranolol Assessed from the Reduction of Ventricular Arrhythmias in the Cycloergometer Test

Cocco¹,

Gori²,

Burkart³

et al. 1982

Cardiology

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An 8-day, double-blind crossover study was carried out in 10 patients with frequent ventricular extrasystoles. On day 1 all patients received placebo. On days 3 and 5 the patients received either propranolol or tiapamil according to a randomized double-blind crossover design, and on the final day all patients again received placebo. All test drugs were given by intravenous infusion. The propranolol dosage was 0.1 mg/kg loading dose followed by 1.5 µg/kg/min for 15 min. Tiapamil dosage was 1 mg/kg followed by 50 µg/kg/min for 15 min. Maximal exercise tests were performed after each drug administration (standardized cycloergometry).For the group as a whole, the total number (65.4 ± 26.4 and 55.9 ± 29.7, mean ± SD, not significant) and types of ventricular extrasystoles were similar during the two control (placebo) periods although, in some individual patients, differences were marked. Compared with their corresponding controls, both tiapamil and propranolol reduced the total number of ventricular extrasystoles (24.6 ± 23.6, -62.4%, and 26.6 ± 27.8, -59.3%, respectively; p < 0.01), their antiarrhythmic effect being similar. As is evident from the large standard deviations, there was a marked interpatient variability in antiarrhythmic effect. The effects of tiapamil and propranolol on the systolic blood pressure and heart rate were typical of these drugs and, therefore, different. Tiapamil reduced the systolic blood pressure both at rest (-8%) and at peak exercise (-6.1 %), the changes being statistically significant (p < 0.05). The heart rate was reduced (-4.5%, p < 0.05) at rest and increased slightly (+3%, n.s.) at peak exercise. Propranolol, on the other hand, did not affect the systolic blood pressure at rest, but decreased it by 8.9% (p < 0.01) at peak exercise and reduced the heart rate both at rest (-17.6%, p < 0.001) and at peak exercise (-7%, p < 0.01). Both drugs were well tolerated.

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“…In a small study tiapamil effectively restored SR and prevented tachycardias in patients with recurrent PSVT except in those with retrograde conduction involving an accessory pathway [270]. Tiapamil was also without effect in WPW syndrome patients on anterograde or retrograde RPs of the accessory pathway or on that of the ventricle [271]. Tiapamil (3 times 200 mg per os daily) had positive effects in supraventricular and ventricular extrasystoles in 23 patients with extrasystoles of different origin [272].…”

Section: Clinical Evidence For the Antiarrhythmic Actions Of Tiapamilmentioning

confidence: 99%

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

Szentandrássy

Nagy²,

Hegyi³

et al. 2014

CPD

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Cardiac arrhythmias are a major cause of morbidity and mortality in the industrialized world. Among their treatment regimens one can find the calcium channel antagonists (CCAs), the class IV agents. In the cardiovascular system Land T-type calcium channels are found on vascular smooth muscle cells and cardiac myocytes with well defined physiological roles. Inhibition of calcium channels by CCAs has widely been used in clinical practice for several decades. Cardiovascular disorders are one of the many fields of medicine in which CCAs are used for various reasons and conditions. The three main indications of them are hypertension, angina and various cardiac arrhythmias. The most important classes of CCAs are dihydropyridines, phenylalkylamines and benzothiazepines but some newer compounds do not fall into any of these major classes. Dihydropyridines are not used in the antiarrhythmic therapy but are good vasodilators and antianginal agents. In contrast, phenylalkylamines and benzothiazepines exert cardiac actions in vivo and therefore these are one choice of antiarrhythmic drugs. This review focuses on phenylalkylamines, benzothiazepines and on new drugs with potential antiarrhythmic action in the heart as well as the mechanisms how calcium channels antagonism can lead to an antiarrhythmic action.

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Effect of Tiapamil in the Wolff-Parkinson-White Syndrome

Cited by 12 publications

References 0 publications

Electrophysiology of Tiapamil in Concealed Accessory Pathways

Electrophysiology of Tiapamil in Concealed Accessory Pathways

Antiarrhythmic Effects of Tiapamil and Propranolol Assessed from the Reduction of Ventricular Arrhythmias in the Cycloergometer Test

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

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