Nifekalant hydrochloride, a novel class III antiarrhythmic agent, suppressed postoperative recurrent ventricular tachycardia in a patient undergoing coronary artery bypass grafting and the Dor approach.
A patient with 3-vessel coronary artery disease and left ventricular aneurysm underwent coronary artery bypass grafting combined with the Dor approach. Five days later, ventricular tachycardia following short-coupled ventricular premature contractions suddenly occurred and was not responsive to class IB drugs (lidocaine and mexiletine), requiring frequent electrical cardioversion. After the administration of a novel class III drug, nifekalant hydrochloride, this electrical storm of ventricular tachycardia was completely suppressed together with the disappearance of ventricular premature contractions. Nifekalant hydrochloride (MS-551), a pure K(+) channel blocker, might be effective for postoperative recurrent ventricular tachyarrhythmias that are refractory to other antiarrhythmic agents.
Sahara
Makoto
M
The Cardiovascular Institute Hospital, Tokyo, Japan. saharam-tky@umin.ac.jp
Sagara
Kouichi
K
Yamashita
Takeshi
T
Iinuma
Hiroyuki
H
Fu
Long-Tai
LT
Watanabe
Hiroshi
H
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000145:classification / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004351:Drug Resistance; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008801:Mexiletine / Q000627:therapeutic use; D026902:Potassium Channel Blockers / Q000627:therapeutic use*; D011744:Pyrimidinones / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D026902:Potassium Channel Blockers; D011744:Pyrimidinones; D008801:Mexiletine; C076259:nifekalant; D008012:Lidocaine