conversion with verapamil?

[zzyzx]

Has anyone ever seen a patient convert from AF to sinus rhythm after being given verapamil? What about other calcium-channel blockers?

[Kaisu]

I've seen them convert with diltiazem... kinda a bummer if you were only trying to control the rate....

PS - I've seen an ER doc convert afib with metoprolol and mag... not calcium channel blocker but the mag sorta does that....

[AZCEP]

I've had it happen a couple of times. It does tend to surprise you a bit, but it really isn't an anomolous thing to have happen. The rate of atrial discharge is slowed enough that the SA can resume it's proper function. Most texts don't bother to mention it, because it isn't supposed to work that way, but we all know that if a patient has read the "book", they have surely forgotten what it said.

[Niftymedi911]

I've only seen Cardizem slow the rates down, never actually "converting" them.

[medic_texas]

In the hospital, the cardiologists prefer Cordarone to convert A-fib. Verapamil is used for our neuro patients to decrease and stop vasosasms. The verapamil is injected directly into the vessel inside the brain during an angiogram. The patient also receives nimotop, another CCB, a few times daily to help with vasospasms. Neuro patients who have had a brain injury do very crappy when they have vasospasms of the brain.

Just other uses and other treatments for meds.

We used to carry verapamil on the ambulance when I first started EMS for SVT.

[Doczilla]

Yes.

'zilla

[1EMT-P]

Cardizem & Verapamil are both calcium channel blockers. Verapamil is the older of the two drugs & yes it can be used for atrial fib., but please keep in mind that Verapamil is no longer considered a first line drug for the treatment of atrial fib.

[Quakefire]

I've only seen amiodarone used in the ER. The guy had a history of SVT, this time it was AFib his ECG showed a right bundle branch block. Took him the better part of 6 hours to convert.

[paraloco]

I converted a guy in atrial flutter with cardizem, per my protocol. The cardiologist who took over from the er doc had a big problem with it, but it converted him to a normal sinus rhythm, and he felt much better.

[Kaisu]

I converted a guy in atrial flutter with cardizem, per my protocol. The cardiologist who took over from the er doc had a big problem with it, but it converted him to a normal sinus rhythm, and he felt much better.

Was it your intention to convert - or to control the rate? What was the onset of aflutter?