PEDIATRICS Vol. 75 No. 4 April 1985, pp. 737-740
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Cardiac Decompensation Following Verapamil Therapy in Infants with Supraventricular Tachycardia

Michael L. Epstein MD1, Ernest A. Kiel MD1, and Benjamin E. Victorica MD1

1 From the Department of Pediatrics, Division of Cardiology, University of Florida College of Medicine, Gainesville, and Department of Pediatrics, Division of Cardiovascular Services, University of Arkansas for Medical Sciences, Little Rock

Three infants with supraventricular tachycardia and congestive cardiac failure were given verapamil intravenously. In two of the infants, the rhythm was converted to sinus, but the third infant required direct current cardioversion. However, each infant demonstrated hemodynamic decompensation shortly after verapamil administration and required cardiopulmonary resuscitation. All three patients were stabilized and their tachycardia was controlled with digoxin. All three were doing well at the time of follow-up evaluation, and there was no evidence of structural heart disease. The risk of cardiac decompensation in infants with supraventricular tachycardia and congestive cardiac failure should be kept in mind prior to administration of verapamil. Alternative methods for conversion of supraventricular tachycardia should be considered.

Key Words: verapamil • supraventricular tachycardia • cardiac decompensation

Submitted on January 31, 1984
Accepted on June 6, 1984




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