[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.
Department of Cardiovascular Surgery, Cardiovascular Center, Okayama Central Hospital, Okayama, Japan.
Hiroshi
H
Furukawa
Hitoshi
H
Aono
Masanobu
M
Samukawa
Kohichiro
K
Iwasaki
Akihiko
A
Ohkado
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