Influence of Intravenous Diltiazem on Left Ventricular Function in Patients With Severe Coronary Artery Disease at Rest and During Pacing, Monitored by Computer-Processed Nuclear Probe and Tip-Manometer Data

The influence of intravenous diltiazem on hemodynamics and left ventricular function indices was studied in 14 patients with severe coronary artery disease at rest and during atrial pacing. We used a tip manometer catheter for recording left ventricular pressure tracings and a nuclear probe for measuring left ventricular volume changes. Infusion of diltiazem at rest resulted in an increase in left ventricular enddiastolic volume (+ 16%, p <0.0001); allother parameters did not differ significantly from baseline values. Angina pectoris occurred in all patients during atrial pacing before diltiazem infusion (ContrP); during pacing after diltiazem infusion (DiltP) only four patients became symptomatic (at the same pacing rates). Other differences between the two pacing studied and their baseline measurement were mean arterial pressure (ContrP: +13%, p <0.001; DiltP: +11% p <0.001), pulmonary wedge pressure (ContrP: +54%, p = 0.019; DiltP: NS), left ventricular enddiastolic pressure (ContrP: +40%, p