[Clinical experience with intravenous administration of nifekalant hydrochloride for ventricular tachycardia in a hemodialysis patient after open heart surgery].
A 78-year-old man with chronic renal failure (CRF) on hemodialysis (HD) was diagnosed as having severe aortic regurgitation with left ventricular dysfunction. Aortic valve replacement with a 21 mm ATS mechanical bileaflet prosthesis was performed without intraoperative complications. Sustained ventricular tachycardia suddenly occurred 1 day after surgery, then intravenous administration of nifekalant hydrochloride (NIF) was started at a dose of 0.40 mg/kg/hr. Life-threating ventricular arrhythmia was controlled, hemodynamic compromise was improved dramatically. NIF was regulated with a low-dose of 0.24 mg/kg/hr to prevent malignant side effect such as torsa de pointes. Since QTc was elongated to 0.57 seconds 11 hours after administration, NIF was stopped. Low-dose intravenous administration of NIF in patients with CRF on HD could be useful to prevent ventricular tachyarrhythmias without any adverse effect after cardiac surgery.
Furukawa
Hiroshi
H
Department of Cardiovascular Surgery, Cardiovascular Center, Okayama Central Hospital, Okayama, Japan.
Aono
Hitoshi
H
Samukawa
Masanobu
M
Iwasaki
Kohichiro
K
Ohkado
Akihiko
A
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery*; D006350:Heart Valve Prosthesis; D015312:Hemodialysis Solutions; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D011183:Postoperative Complications; D011744:Pyrimidinones / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000188:drug therapy*
D000889:Anti-Arrhythmia Agents; D015312:Hemodialysis Solutions; D011744:Pyrimidinones; C076259:nifekalant