Intravenous calcium chloride in the conversion of paroxysmal supraventricular tachycardia to normal sinus rhythm

Am J Emerg Med. 1996 Jan;14(1):50-2. doi: 10.1016/S0735-6757(96)90015-7.

Abstract

This brief report describes several cases of paroxysmal supraventricular tachycardia that converted promptly to normal sinus rhythm within 1 to 2 minutes of receiving intravenous calcium salts as pretreatment in anticipation of verapamil therapy. A review of calcium's hemodynamic and dromotropic effects suggests that this probably was due to electrophysiological effects rather than mere coincidence. Calcium raises blood pressure, which may reflexively increase cardiac parasympathetic tone, and also has a direct slowing effect on atrioventricular conduction. Adenosine remains the drug of choice in the treatment of paroxysmal supraventricular tachycardia. However, in addition to preventing hypotension when used as pretreatment to verapamil, intravenous calcium itself may terminate supraventricular tachycardia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / therapeutic use*
  • Calcium Chloride / pharmacology
  • Calcium Chloride / therapeutic use*
  • Drug Therapy, Combination
  • Electrocardiography
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Premedication / methods*
  • Tachycardia, Paroxysmal / complications
  • Tachycardia, Paroxysmal / drug therapy*
  • Tachycardia, Supraventricular / complications
  • Tachycardia, Supraventricular / drug therapy*
  • Verapamil / therapeutic use*

Substances

  • Anti-Arrhythmia Agents
  • Verapamil
  • Calcium Chloride