title: Nifekalant hydrochloride suppresses severe electrical storm in patients with malignant ventricular tachyarrhythmias.
abstract: 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.
authors.affiliation: First Department of Internal Medicine Niigata University Hospital, Asahimachi, Niigata, Japan. washi@med.niigata-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Washizuka
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hosaka
authors.forename: Satoru
authors.initials: S
authors.lastname: Komura
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sugiura
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furushima
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: 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*
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D006993:Hypnotics and Sedatives; D011744:Pyrimidinones; C076259:nifekalant