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Cited by 152Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Efficacy and safety of intravenous diltiazem for treatment of atrial fibrillation and atrial flutter

Salerno, David M., Dias, Virgil C., Kleiger, Robert E., Tschida, Victor H., Sung, Ruey J., Sami, Magdi, Giorgi, Lee V.·1989·The American Journal of Cardiology
DOI 10.1016/0002-9149(89)90076-3
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Abstract

This study evaluates the effectiveness and safety of intravenous diltiazem for the treatment of atrial fibrillation and atrial flutter. A double-blind, parallel, randomized, placebo-controlled protocol was used, and 6 large, urban hospitals, both university-affiliated and private, participated. The study involved 113 patients with atrial fibrillation or flutter, a ventricular rate greater than or equal to 120 beats/min and systolic blood pressure greater than or equal to 90 mm Hg without severe heart failure. The dose of intravenous diltiazem (or identical placebo) was 0.25 mg/kg/2 minutes followed 15 minutes later by 0.35 mg/kg/2 minutes if the first dose was tolerated but ineffective. If a patient did not respond, the code was broken and the patient was allowed to receive open-label diltiazem if placebo had been given. Of 56 patients, 42 (75%) randomized to receive diltiazem responded to 0.25 mg/kg and 10 of 14 responded to 0.35 mg/kg, for a total response rate of 52 of 56 patients (93%), whereas 7 of 57 patients (12%) responded to placebo (p less than 0.001). After the double-blind protocol, 49 of the 57 patients who received placebo were then given diltiazem; 47 of 49 responded, for an overall response rate of 99 of 105 patients (94%) with diltiazem. The median time from the start of drug infusion to the maximal decrease in heart rate was 4.3 minutes. Side effects occurred in 14 patients, 7 of whom had asymptomatic hypotension not requiring intervention. Thus, intravenous diltiazem was rapidly effective for slowing the ventricular response in most patients with atrial fibrillation or atrial flutter. Blood pressure decreased slightly. Side effects were mild.

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Crossref · 10.1016/0002-9149(89)90076-3

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Metadata

Authors
Salerno, D. M., Dias, V. C., Kleiger, R. E., Tschida, V. H., Sung, R. J., Sami, M., & Giorgi, L. V.
Affiliations
San Francisco General Hospital (US)
Corresponding author
Salerno, David M.
ORCID
Salerno, David M.
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
1989-05
Volume
63
Issue
15
Pages
1046-1051
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/0002-9149(89)90076-3
OpenAlex
W1998994470
Cited by
152
References
23
Citations by year
2025: 4 · 2024: 1 · 2023: 1 · 2021: 3 · 2020: 5 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 8 · 2014: 2 · 2013: 1 · 2012: 2
FWCI
6.54
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
atrial fibrillation, atrial flutter, ventricular rate control, calcium channel blockers, antiarrhythmic efficacy, drug safety, hypotension, placebo response
MeSH terms
Aged, Atrial Fibrillation, Atrial Flutter, Blood Pressure, Diltiazem, Double-Blind Method, Female, Heart Rate, Humans, Injections, Intravenous, Male, Middle Aged, Random Allocation, Multicenter Studies as Topic

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