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(Chest. 1988;93:20-25.)
© 1988 American College of Chest Physicians

Diltiazem and Exercise Performance in Patients with Chronic Atrial Fibrillation

J. Edwin Atwood M.D.1; Jonathan N. Myers M.A.1; Michael J. Sullivan M.A.1; Susan M. Forbes R.N.1; William F. Pewen M.S.1; and Victor F. Froelicher M.D., F.C.C.P.1

1 From the Cardiology Section, Veterans Administration Medical Center, Long Beach, CA.

To evaluate the influence of calcium entry blockade (diltiazem 60 mg qid) on exercise capacity in patients with chronic atrial fibrillation, nine men (mean age 65 years) with atrial fibrillation underwent maximal treadmill exercise on and off diltiazem therapy. Heart rate, blood pressure, and measured ventilatory parameters were assessed at a standard submaximal workload (3.0 mph/0% grade), the gas exchange anaerobic threshold (ATge), and maximal exercise. Significant reductions in heart rate at all stages of exercise were demonstrated: maximum heart rate decreased from 171±30 beats/min to 142±27 beats/min (17 percent, p<.01) and submaximal exercise heart rate decreased from 123±22 beats/min to 96±16 beats/min (22 percent, p<.01). However, there were no significant changes in blood pressure or gas exchange data, ie, oxygen uptake, minute ventilation, or respiratory exchange ratio at any of the exercise workloads. These data demonstrate that in patients with chronic atrial fibrillation, diltiazem controls the ventricular rate response throughout exercise without attenuating blood pressure or exercise capacity.

Submitted on April 27, 2007
Accepted on July 2, 2007




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R. Farshi, D. Kistner, J. S. M. Sarma, J. A. Longmate, and B. N. Singh
Ventricular rate control in chronic atrial fibrillation during daily activity and programmed exercise: a crossover open-label study of five drug regimens
J. Am. Coll. Cardiol., February 1, 1999; 33(2): 304 - 310.
[Abstract] [Full Text] [PDF]


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