Summary
Three patients presented to the emergency room with atrial fibrillation and fast ventricular response with wide preexcited QRS complexes (Wolff-Parkinson-White syndrome). All three patients received intravenous verapamil (5–10mg). The first patient developed ventricular fibrillation requiring several defibrillations; the second patient developed severe hemodynamic deterioration requiring urgent cardioversion; in the third patient a marked increment in the ventricular response was noted, however, there was no hemodynamic impairment.
Verapamil may cause detrimental results when given to patients with the Wolff-Parkinson-White syndrome and atrial fibrillation. Its administration should therefore be considered as an absolute contraindication in these patients.
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Strasberg, B., Sagie, A., Rechavia, E. et al. Deleterious effects of intravenous verapamil in Wolff-Parkinson-White patients and atrial fibrillation. Cardiovasc Drug Ther 2, 801–806 (1989). https://doi.org/10.1007/BF00133211
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DOI: https://doi.org/10.1007/BF00133211