Author + information
- Received May 11, 1988
- Revision received November 11, 1989
- Accepted November 26, 1989
- Published online April 1, 1989.
- Osamu Fujimura, MD,
- George J. Klein, MD, FRCPC, FACC∗,
- Arjun D. Sharma, MD, FRCPC, FACC,
- Raymond Yee, MD, FRCPC and
- Tibor Szabo, MD
- ↵∗Address for reprints: G.J. Klein, MD, University Hospital, Box 5339, Station A, London, Ontario, Canada N6A 5A5.
Disopyramide was administered intravenously to 54 patients during atrial fibrillation and predominantly preexcited QRS configuration at the time of electrophysiologic study. All patients had Wolff-Parkinson-White syndrome and no patient had coexistent heart disease. The drug was given during sustained atrial fibrillation (n = 45) or during sinus rhythm before induction of atrial fibrillation for patients whose atrial fibrillation was self-terminating in the control state (n = 9). Atrial fibrillation converted to sinus rhythm within 15 min after disopyramide in 37 (82%) of the 45 patients. The shortest RR intervals between two preexcited cycles increased from 208 ± 42 to 293 ± 117 ms (p < 0.0001). The average RR interval of all cycles prolonged from 332 ± 60 to 396 ± 117 ms (n = 45, p < 0.0001). The 9 patients in whom pre-excitation was abolished after the drug had a significantly longer initial shortest RR interval than that of the 36 patients in whom pre-excitation persisted (246 ± 47 versus 199 ± 36 ms, p = 0.0022). No patients developed significant hemodynamic or other adverse effects after disopyramide.
These data support the intravenous use of disopyramide in patients with normal ventricular function who have atrial fibrillation and a predominant ventricular response over an accessory atrioventricular pathway.
☆ This study was supported by the Ontario Heart and Stroke Foundation of Ontario, Toronto, Ontario. Dr. Klein is a senior Research Fellow of the Heart and Stroke Foundation. Drs. Sharma and Yee are Career Scientists of the Ministry of Health, Toronto.
- Received May 11, 1988.
- Revision received November 11, 1989.
- Accepted November 26, 1989.