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Comparison of verapamil versus felodipine on heart rate variability after acute myocardial infarction.
- Source :
-
The American journal of cardiology [Am J Cardiol] 1997 Mar 01; Vol. 79 (5), pp. 564-9. - Publication Year :
- 1997
-
Abstract
- A depressed heart rate variability (HRV) is a powerful predictor of poor outcome in myocardial infarction patients. The beneficial effect of specific interventions on its recovery has been reported, but data concerning calcium antagonists are scarce. We evaluated the effect of a phenylalkylamine derivative, verapamil, and a dihydropyridine derivative, felodipine, on time- and frequency-domain measurements of HRV by 24-hour Holter monitoring in 60 patients with acute myocardial infarction (AMI). After a first Holter recording (65 +/- 8 hours from the onset of symptoms), patients were randomly assigned to continue standard treatment or to also receive verapamil retard (120 mg 3 times daily) or felodipine extended-release (10 mg/day). Holter recording was repeated after 7 days. After verapamil, mean RR interval increased from 823 +/- 92 to 907 +/- 95 ms and the SD of all normal RR (NN) intervals (SDNN) from 99 +/- 24 to 120 +/- 30 ms (p < 0.01); the root mean square successive difference (r-MSSD) and the percent of differences between adjacent NN intervals > 50 ms (pNN50) also increased (p < 0.01). After felodipine, only SDNN increased (p < 0.01). Regarding frequency-domain measurements, after receiving verapamil, very low frequency, low- and high-frequency powers increased (p < 0.01), whereas the low- to high-frequency ratio decreased (p < 0.01). After receiving felodipine, very low-frequency power increased (p < 0.01), whereas low- and high-frequency powers and the low- to high-frequency ratio remained unchanged. This study demonstrates that verapamil, but not felodipine, improves HRV in the early phase after AMI.
- Subjects :
- Blood Pressure drug effects
Calcium Channel Blockers administration & dosage
Delayed-Action Preparations
Electrocardiography, Ambulatory drug effects
Felodipine administration & dosage
Female
Follow-Up Studies
Forecasting
Humans
Male
Middle Aged
Myocardial Infarction physiopathology
Single-Blind Method
Thrombolytic Therapy
Time Factors
Treatment Outcome
Verapamil administration & dosage
Calcium Channel Blockers therapeutic use
Felodipine therapeutic use
Heart Rate drug effects
Myocardial Infarction drug therapy
Verapamil therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9149
- Volume :
- 79
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 9068509
- Full Text :
- https://doi.org/10.1016/s0002-9149(96)00816-8