VERAPAMIL IN THE TREATMENT OF MATERNAL PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

被引:31
作者
BYERLY, WG
HARTMANN, A
FOSTER, DE
TANNENBAUM, AK
机构
[1] Drug Information Service, Department of Pharmacy, North Carolina Baptist Hospital, Winston-Salem, NC
[2] Department of Emergency Medicine, Robert Wood Johnson University Hospital, New Brunswick, NJ
[3] Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, NJ
[4] Division of Cardiovascular Diseases and Hypertension, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
关键词
paroxysmal supraventricular tachycardia; verapamil;
D O I
10.1016/S0196-0644(05)81615-4
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Paroxysmal supraventricular tachycardia (PSVT) is seen somewhat frequently in the emergency department but less frequently during pregnancy. Although verapamil is widely used as the drug of choice for PSVT with a narrow QRS complex in a hemodynamically stable patient, the acute IV use of verapamil during pregnancy has not been well studied. Only a limited number of case reports document its safety and efficacy in the treatment of maternal or fetal PSVT. In general, the use of medication during pregnancy requires careful assessment of both the maternal and fetal risks versus benefits and documentation of patient consent. Because it crosses the placenta, one of the major concerns with the acute use of IV verapamil centers around the drug's potential effect on fetal heart rate. The case we present describes the occurrence of PSVT on two separate occasions in a woman in the third trimester of pregnancy. In both episodes, as much as 10 mg IV verapamil was given with resulting successful conversion to normal sinus rhythm. Fetal heart monitoring during drug administration failed to show significant change in fetal heart rate.
引用
收藏
页码:552 / 554
页数:3
相关论文
共 10 条
[1]  
Singh, Nardemanee, Baky, Calcium antagonists: Clinical use in the treatment of arrhythmias, Drugs, 25, pp. 125-153, (1983)
[2]  
Klein, Repke, Supraventricular tachycardia in pregnancy: Cardioversion with verapamil, Obstet Gynecol, 63, pp. 165-185, (1984)
[3]  
Wolff, Breuker, Schlensker, Et al., Prenatal diagnosis and therapy of fetal heart rate anomalies: With a contribution on the placental transfer of verapamil, J Perinat Med, 8, pp. 203-208, (1980)
[4]  
Bergmans, Jonker, Kock, Fetal supraventricular tachycardia: Review of the literature, Obstet Gynecol Surv, 40, pp. 61-68, (1985)
[5]  
Kleinman, Copel, Weinstein, Et al., Treatment of fetal supraventricular tachyarrhythmias, J Clin Ultrasound, 13, pp. 265-273, (1985)
[6]  
Rotmensch, Elkagam, Frishman, Antiarrhythmic drug therapy during pregnancy, Ann Intern Med, 98, pp. 487-497, (1983)
[7]  
FDA Drug Bull, 12, pp. 24-25, (1982)
[8]  
Mitani, Steinberg, Lieu, Et al., The pharmacokinetics of antiarrhythmic agents in pregnancy and lactation, Clin Pharmacokinet, 12, pp. 253-291, (1987)
[9]  
Schroeder, Harrison, Repeated cardioversion during pregnancy, Am J Cardiol, 27, pp. 445-446, (1971)
[10]  
Klepper, Cardioversion in later pregnancy, Anaesthesia, 36, pp. 611-616, (1981)