Nifekalant hydrochloride suppresses severe electrical storm in patients with malignant ventricular tachyarrhythmias.
BACKGROUND
Some patients with an implantable cardioverter-defibrillator (ICD) suffer from burst of inappropriate multiple discharges (severe electrical storm), and because the current therapeutic options are limited, the effect of nifekalant hydrochloride, a new class III drug, on severe electrical storm was investigated in the present study.


RESULTS
Ninety-one consecutive patients treated with ICD were included in the study (M 70; mean age 58 years; left ventricular ejection fraction 45+/-15%). Severe electrical storm was defined as more than 10 ICD discharges within 1 h. During a mean follow-up period of 30+/-13 months, 41/91 (45%) patients had appropriate ICD therapy for arrhythmias and severe electrical storm occurred in 11 of them (12%) at 20+/-18 months after ICD implantation. The mean number of ICD discharges/h during severe electrical storm was 18+/-12. In 4 of 10 patients, severe electrical storm was successfully suppressed by a combination of deep sedation and beta-blocking agent; 6 other patients were refractory to this treatment, but severe electrical storm was successfully suppressed by intravenous administration of nifekalant hydrochloride with no adverse effects.


CONCLUSIONS
Nifekalant hydrochloride is an effective and safe treatment for severe electrical storm.
Washizuka
Takashi
T
First Department of Internal Medicine Niigata University Hospital, Asahimachi, Niigata, Japan. washi@med.niigata-u.ac.jp
Chinushi
Masaomi
M
Watanabe
Hiroshi
H
Hosaka
Yukio
Y
Komura
Satoru
S
Sugiura
Hirotaka
H
Hirono
Takashi
T
Furushima
Hiroshi
H
Tanabe
Yasutaka
Y
Aizawa
Yoshifusa
Y
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000627:therapeutic use; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016879:Salvage Therapy / Q000379:methods; D017180:Tachycardia, Ventricular / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D006993:Hypnotics and Sedatives; D011744:Pyrimidinones; C076259:nifekalant