[The efficiency of nifekalant hydrochloride for the prevention of ventricular tachycardia during cardiac surgery].
Many cases have been successfully treated by us with experimented nifekalant hydrocholoride to prevent ventricular tachycardia (VT) during cardiac surgery. The 13 patients who underwent cardiac surgery at our hospital from 1999 to 2002 were retroactively given nifekalant hydrocholoride against VT. Lidocaine hydrochloride was not effective for VT, and it was difficult for 3 patients to be weaned for cardio-pulmonary bypass, while 6 patients needed aortic balloon pumping or percutaneous cardio-pulmonary support. Nifekalant hydrochloride suppressed VT induction in 9 patients (69.2%). Blood pressure and heart rate did not change, but QTc intervals were significantly increased with nifekalant hydrochloride (p < 0.005). Proarrhythmic events (Torsades de pointes) occurred in 2 patients, but none of the cases showed drug-induced worsening of cardiac function. Nifekalant hydrochloride is a class III antiarrhythmic drug that has been found to be effective against VT and ventricular fibrillation. While class I antiarrhythmic drugs are usually ineffective and induce severe heart failure, nifekalant hydrochloride can be effective.
Sakaguchi
M
M
Department of Cardiovascular Surgery, National Nagano Hospital, Ueda, Japan.
Takemura
T
T
Shimamura
Y
Y
Tsuda
Y
Y
Iwasa
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013504:Cardiovascular Surgical Procedures; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011744:Pyrimidinones / Q000008:administration & dosage*; D017180:Tachycardia, Ventricular / Q000517:prevention & control*; D016896:Treatment Outcome
D011744:Pyrimidinones; C076259:nifekalant