[Successful hybrid therapy combined with oral bepridil and ICD in a patient with amiodarone refractory life-threatening ventricular tachyarrhythmia associated with ischemic cardiomyopathy].
A 68-year-old man was admitted to our hospital for the treatment of angina and ventricular tachyarrhythmia. A coronary and left ventricular angiography showed coronary artery disease and ischemic cardiomyopathy with severe left ventricular dysfunction. A percutaneous transluminal coronary angioplasty was performed successfully in the right coronary artery and his angina symptoms disappeared. However, ventricular tachycardia (VT)/ventricular fibrillation (VF) occurred spontaneously and converted to sinus rhythm with direct current shock (300 J). Oral amiodarone (200 mg/day) and continuous intravenous infusion of nifekalant and lidocaine were started. In addition, a dual chamber implantable cardioverter defibrillator (ICD) for his VT/VF was implanted. However, VT/VF occurred repeatedly after discontinuation of nifekalant. After the administration of bepridil (200 mg/day), VT/VF was completely prevented without nifekalant administration. The hybrid therapy with ICD and oral bepridil is very useful for the treatment of amiodarone resistant ventricular tachyarrhythmia.
Oginosawa
Yasushi
Y
Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Abe
Haruhiko
H
Suzuki
Yoshiyuki
Y
Okazaki
Masahiro
M
Nakashima
Yasuhide
Y
D000284:Administration, Oral; D000368:Aged; D015764:Bepridil / Q000008:administration & dosage*; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications*; D017180:Tachycardia, Ventricular / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000628:therapy*
D015764:Bepridil