Questions

Why are calcium channel blockers problematic in patients with ventricular arrhythmias?

Why are calcium channel blockers problematic in patients with ventricular arrhythmias?

Calcium channel blockers have no proven depressant effect on accessory pathway conduction. Similarly, the value of these agents in the treatment of ventricular tachycardia in association with chronic coronary artery disease and idiopathic dilated cardiomyopathy is rather limited.

Can verapamil be used in ventricular dysrhythmias?

It is not an effective drug against ventricular arrhythmias unless due to coronary artery spasm. The use of verapamil should be avoided in the presence of sick sinus node syndrome, clinical cardiac failure and treatment with other negative inotropic drugs.

Is verapamil used for ventricular tachycardia?

Verapamil, the drug of choice for conversion of most cases of paroxysmal supraventricular tachycardia, has also displayed some efficacy in the treatment of ventricular tachycardia. A case in which the administration of intravenous verapamil resulted in conversion of ventricular tachycardia to sinus rhythm is presented.

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Can verapamil cause heart arrhythmias?

fainting. fast heartbeat, palpitations, irregular heartbeat, or chest pain.

Why verapamil is contraindicated in patient with heart failure?

The calcium channel blockers, verapamil and diltiazem, should generally be avoided in patients with CHF, as their negative inotropic effects may exacerbate the disease.

How do the antiarrhythmic drugs verapamil and diltiazem work?

Diltiazem and verapamil work by reducing the movement of calcium into the AV-node and in the arteries and veins. This causes the force and rate of the heart’s contractions to decrease. This relaxes the arteries and then reduces blood pressure (BP).

How does verapamil work for arrhythmias?

When used to treat arrhythmias, such as Atrial Fibrillation, verapamil prolongs the refractory period (the period immediately following electrical stimulation of the AV node) and slows the heart rate. Verapamil can also lower blood pressure. Verapamil belongs to the class of drugs known as calcium channel blockers.

How does verapamil affect the heart?

Verapamil is a calcium channel blocker. It works by affecting the movement of calcium into the cells of the heart and blood vessels. As a result, verapamil relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload .

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Why is verapamil contraindicated with beta blockers?

The combination of verapamil or diltiazem with beta‐blockers should be avoided because of potentially profound adverse effects on AV (atrioventricular) nodal conduction, heart rate, or cardiac contractility.

Why is verapamil contraindicated in AFIB?

Patients with atrial flutter or atrial fibrillation and an accessory bypass tract (e.g., Wolff Parkinson-White, Lown-Ganong-Levine syndromes). These patients are at risk to develop ventricular tachyarrhythmia including ventricular fibrillation if Verapamil is administered.

What is the difference between verapamil and diltiazem?

Verapamil has a more profound effect on gut smooth muscle than the other calcium channel antagonists. It reduces gut motility and causes constipation. Like verapamil, diltiazem is an arteriolar dilator which reduces peripheral resistance and thus blood pressure, but it is less cardio depressant.

Why is verapamil contraindicated to patients with heart failure?

In patients with normal or mildly impaired left ventricular function, verapamil’s vasodilator and negative inotropic effects are counterbalanced. With severe left ventricular dysfunction, however, treatment with verapamil can result in abrupt decompensation and development of overt pulmonary edema and hypotension.

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Is verapamil contraindicated in patients with ventricular tachycardia?

The use of intravenous diltiazem or verapamil is contraindicated in patients with ventricular tachycardia. IV administration of a calcium channel blocker can precipitate cardiac arrest in such patients.

What is verapamil used to treat?

Verapamil remains the most widely used calcium antagonist for the treatment of cardiac arrhythmias. It is the most potent and effective drug for the acute treatment of paroxysmal supraventricular tachycardia particularly, circus movement tachycardia with or without pre-excitation. 2.

Can verapamil cause congestive heart failure?

Verapamil (Includes verapamil) ↔ CHF/AMI. However, congestive heart failure or pulmonary edema have developed in approximately 2\% of patients treated with verapamil. Mild symptoms of cardiac failure should be under control, if possible, prior to initiating verapamil therapy.

Is verapamil contraindicated in patients with Wolff-Parkinson-White syndrome?

The use of verapamil is contraindicated for the management of atrial flutter or fibrillation in patients with an accessory AV tract (e.g., those with Wolff-Parkinson-White or Lown-Ganong-Levine syndrome).