Skip to main content
SpringerLink
Log in

Verapamil in Infants: An Exaggerated Fear?

  • Review Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The use of intravenous verapamil for tachyarrhythmia in infants is widely considered contraindicated due to the perceived risk of hemodynamic collapse after administration. This article reviews the relatively limited evidence that led to this well-known contraindication and highlights the interesting process by which medical practice may evolve in the absence of persuasive science.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CHF:

Congestive heart failure

SVT:

Supraventricular tachycardia

References

  1. Epstein ML, Kiel EA, Victoria BE (1985) Cardiac decompensation following verapamil therapy in infants with supraventricular tachycardia. Pediatrics 75:737–740

    CAS  PubMed  Google Scholar 

  2. Garland JS, Berens RJ, Losek JD, Wilson AD (1985) An infant fatality following verapamil therapy for supraventricular tachycardia: cardiovascular collapse following intravenous verapamil. Pediatr Emerg Care 1:198–200

    Article  CAS  PubMed  Google Scholar 

  3. Kirk CR, Gibbs JL, Thomas R, Radley-Smith R, Qureshi SA (1987) Cardiovascular collapse after verapamil in supraventricular tachycardia. Arch Dis Child 62:1265–1282

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Kugler JD, Danford DA (1996) Management of infants, children, and adolescents with paroxysmal supraventricular tachycardia. J Pediatr 129:324–338

    Article  CAS  PubMed  Google Scholar 

  5. Leitner RP, Hawker RE, Celermajer JM (1983) Intravenous verapamil in the treatment of paroxysmal supraventricular tachycardia in children. Aust Paediatr J 19:40–44

    CAS  PubMed  Google Scholar 

  6. Micromedex 2.0 (2013) http://www.thomsonhc.com/micromedex2/librarian/ND_T/evidencexpert/ND_PR/evidencexpert/CS/E7EBDF/ND_AppProduct/evidencexpert/DUPLICATIONSHIELDSYNC/A2838E/ND_PG/evidencexpert/ND_B/evidencexpert/ND_P/evidencexpert/PFActionId/evidencexpert.DisplayDrugdexDocument?docId=2350&contentSetId=31&title=Verapamil+Hydrochloride&servicesTitle=Verapamil+Hydrochloride&topicId=dosingInformationSection&subtopicId=pediatricDosageSection. Accessed 28 Jan 2013

  7. Moran AM, Colan SD (1998) Verapamil therapy in infants with hypertrophic cardiomyopathy. Cardiol Young 8:310–319

    CAS  PubMed  Google Scholar 

  8. Radford D (1983) Side effects of verapamil in infants. Arch Dis Child 58:465–466

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Rea RF, Hamdan M, Schomer SJ, Geraets DR (1991) Inhibitory effects of procainamide on sympathetic nerve activity in humans. Circ Res 69:501–508

    Article  CAS  PubMed  Google Scholar 

  10. Saul JP, Scott WA, Brown S, Marantz P, Acevedo V, Etheridge SP et al (2005) Intravenous amiodarone for incessant tachyarrhythmias in children: a randomized, double-blind, antiarrhythmic drug trial. Circulation 112:340–3477

    Article  Google Scholar 

  11. Shahar E, Barzilay Z, Frand M (1981) Verapamil in the treatment of paroxysmal tachycardia in infants and children. J Pediatr 98:323–325

    Article  CAS  PubMed  Google Scholar 

  12. Snyder C, Bishara J, Darling R, Lucas V (2006) Verapamil-sensitive ventricular tachycardia in an infant. Congenit Heart Dis 1:124–126

    Article  PubMed  Google Scholar 

  13. Soler-Soler J, Sagrista-Sauleda J, Cabrera A, Sauleda-Pares J, Iglesias-Berengue J, Permanyer-Miralda G et al (1979) Effect of verapamil in infants with paroxysmal supraventricular tachycardia. Circulation 59:876–879

    Article  CAS  PubMed  Google Scholar 

  14. Wetzel GT, Klitzner TS (1996) Developmental cardiac electrophysiology: recent advances in cellular physiology. Cardiovasc Res 31:E52–E60

    Article  PubMed  Google Scholar 

  15. Wetzel GT, Chen F, Klitzner TS (1991) L- and T-type calcium channels in acutely isolated neonatal and adult cardiac myocytes. Pediatr Res 30:89–94

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

No conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Pediatrics and Communicable Diseases, CS Mott Children’s Hospital, University of Michigan, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA

    Martin J. LaPage, David J. Bradley & Macdonald Dick II

Authors
  1. Martin J. LaPage
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David J. Bradley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Macdonald Dick II
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin J. LaPage.

Rights and permissions

Reprints and permissions

About this article

Cite this article

LaPage, M.J., Bradley, D.J. & Dick, M. Verapamil in Infants: An Exaggerated Fear?. Pediatr Cardiol 34, 1532–1534 (2013). https://doi.org/10.1007/s00246-013-0739-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-013-0739-8

Keywords

Search

Navigation