RT-179
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Effects of 200 mg sustained release diltiazem on ventricular rate control in chronic atrial fibrillation (D-D-CAF Study)
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Marcello Chimienti, Vincenzo Santinelli*, Maurizio Moizi**, Gianluca Botto***, Serena Barbieri.
Polyclinic of Monza, Monza, and Department of Internal Medicine, University of Pavia, Pavia,
*Department of Cardiology, University “Federico II”, Naples,
**Division of Cardiology, Sondrio Hospital, Sondrio, ***Division of Cardiology, S. Anna Hospital, Como, Italy
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Abstract
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The efficacy and safety of sustained release diltiazem, at a dose of 200
mg once daily (D200), were compared with those of standard diltiazem, at a dose of 60 mg three times a day (D60)
in patients with chronic atrial fibrillation, to control ventricular rate (D-D-CAF Study). Data were analyzed after
two 7-day treatment periods, in random sequence, as compared to control wash-out findings. The resting heart
rate (HR) was significantly (p<0.001) reduced from 116±19 beats/min to 82±21 (D60) and 87±23 beats/min (D200).
The maximum HR during Holter recording decreased significantly from 158±25 beats/min to 129±29 (p<0.005) and
125±25 beats/min (p<0.001), with D60 and D200, respectively. The longest R-R interval slightly increased from
1860±251 ms to 2306±403 (p<0.01) and 2285±469 ms (NS), while the number of pauses longer than 2000 ms
changed from 0 to a median of 10 and 5, with D60 and D200, respectively. Similar findings were recorded during
a modified 3-minute walking test: the maximum HR significantly decreased (p<0.001) from 160±23 beats/min to
122±32 and 126±32 beats/min and the mean covered distance slightly but significantly increased (p<0.01) from
182±72 meters to 193±70 and 195±69 meters, with the two drug regimens. Finally, the palpitation score (from 0 to
3, according to the severity of symptoms) decreased from 1.7±1.1 to 0.7±0.6 (p<0.01) and 0.6±0.5 (p<0.005), while
the dyspnea score (from 0 to 3) decreased significantly (p<0.05) from 1.5±0.7 to 1.1±0.7 and 1.0±0.7 during the two
diltiazem treatment periods. No significant difference was found between the two drug regimens. No patient
discontinued treatment for adverse experiences. Diltiazem can thus be safely utilized in the 200 mg sustained
release formulation to control ventricular rate in chronic atrial fibrillation.
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Key Words
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