Non-invasive assessment of the effect of beta blockers and calcium channel blockers on the AV node during permanent atrial fibrillation

J Electrocardiol. 2015 Sep-Oct;48(5):861-6. doi: 10.1016/j.jelectrocard.2015.07.019. Epub 2015 Jul 26.


Aim: We aimed at assessing changes in AV nodal properties during administration of the beta blockers metoprolol and carvedilol, and the calcium channel blockers diltiazem and verapamil from electrocardiographic data.

Methods: Parameters accounting for the functional refractory periods of the slow and fast pathways (aRPs and aRPf) were estimated using atrial fibrillatory rate (AFR) and ventricular response assessed from 15-min ECG segments recorded at baseline and on drug treatment from sixty patients with permanent AF.

Results: The results showed that AFR and HR were significantly reduced for all drugs, and that aRPs and aRPf were significantly prolonged in both pathways. The prolongation in aRP was significantly larger for the calcium channel blockers than for the beta blockers.

Conclusions: The changes observed in the AV node parameters are in line with the results of previous electrophysiological studies performed in patients during sinus rhythm, therefore supporting the clinical value of the method.

Keywords: Atrial fibrillation; Atrioventricular node; Beta blocker; Calcium channel blocker; Functional refractory period; Rate control.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage*
  • Aged
  • Anti-Arrhythmia Agents / administration & dosage
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / physiopathology*
  • Atrioventricular Node / drug effects
  • Atrioventricular Node / physiopathology*
  • Calcium Channel Blockers / administration & dosage*
  • Chronic Disease
  • Cross-Over Studies
  • Electrocardiography / drug effects*
  • Electrocardiography / methods
  • Female
  • Heart Conduction System / drug effects
  • Heart Conduction System / physiopathology
  • Heart Rate / drug effects
  • Humans
  • Male
  • Prospective Studies
  • Single-Blind Method
  • Treatment Outcome


  • Adrenergic beta-Antagonists
  • Anti-Arrhythmia Agents
  • Calcium Channel Blockers