Cargando…

Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure

Background: Both nifekalant hydrochloride (NIF), a selective I(Kr) blocker, and intravenous amiodarone (AMD), a multi-channel (including I(Kr) blocking) blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arr...

Descripción completa

Detalles Bibliográficos
Autores principales: Nakagawa, Koji, Nakamura, Kazufumi, Kusano, Kengo Fukushima, Nagase, Satoshi, Tada, Takeshi, Murakami, Masato, Hata, Yoshiki, Morita, Hiroshi, Kohno, Kunihisa, Hina, Kazumasa, Ujihira, Tohru, Ohe, Tohru, Ito, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055956/
http://dx.doi.org/10.3390/ph4060794
_version_ 1782320756775976960
author Nakagawa, Koji
Nakamura, Kazufumi
Kusano, Kengo Fukushima
Nagase, Satoshi
Tada, Takeshi
Murakami, Masato
Hata, Yoshiki
Morita, Hiroshi
Kohno, Kunihisa
Hina, Kazumasa
Ujihira, Tohru
Ohe, Tohru
Ito, Hiroshi
author_facet Nakagawa, Koji
Nakamura, Kazufumi
Kusano, Kengo Fukushima
Nagase, Satoshi
Tada, Takeshi
Murakami, Masato
Hata, Yoshiki
Morita, Hiroshi
Kohno, Kunihisa
Hina, Kazumasa
Ujihira, Tohru
Ohe, Tohru
Ito, Hiroshi
author_sort Nakagawa, Koji
collection PubMed
description Background: Both nifekalant hydrochloride (NIF), a selective I(Kr) blocker, and intravenous amiodarone (AMD), a multi-channel (including I(Kr) blocking) blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arrhythmia with severe heart failure has not been established. Intravenous AMD might be effective for arrhythmias refractory to NIF in patients with severe heart failure. Here, we report that intravenous amiodarone was effective in the treatment of nifekalant-resistant in a group of arrhythmia patients with severe heart failure. Methods: Eleven severe heart failure patients who had received intravenous AMD for treatment of NIF-resistant arrhythmias were included in this study, and retrospective analysis was performed. Clinical efficacy (terminative and preventive effects on arrhythmia) of intravenous AMD was evaluated. Results: All cases were emergent cases and had depressed left ventricular ejection fraction (30 ± 13%). Clinical arrhythmias were ventricular fibrillation (VF) in four patients, ventricular tachycardia (VT) in six patients, and atrial fibrillation (AF) in one patient. NIF was administered to all patients by intravenous injection. After administration of NIF, VT/VF/AF was terminated in seven of the 10 patients, but a preventive effect was not obtained in any of the patients (NIF-resistance). Intravenous AMD (maintenance dose: 484 ± 166 mg/day) was effective both in termination (80%) and in prevention (80%) of VT/VF events in those patients. It was also effective in termination (80%) and prevention (60%) of AF events refractory to NIF. During continuous AMD administration, no significant adverse effects or proarrhythmic effects were observed in any of the patients. Five patients died within one month, but there was no arrhythmic deaths. Conclusions: Intravenous AMD was effective in NIF-resistant lethal arrhythmias and was relatively safe in emergent cases with severe heart failure.
format Online
Article
Text
id pubmed-4055956
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-40559562014-06-13 Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure Nakagawa, Koji Nakamura, Kazufumi Kusano, Kengo Fukushima Nagase, Satoshi Tada, Takeshi Murakami, Masato Hata, Yoshiki Morita, Hiroshi Kohno, Kunihisa Hina, Kazumasa Ujihira, Tohru Ohe, Tohru Ito, Hiroshi Pharmaceuticals (Basel) Article Background: Both nifekalant hydrochloride (NIF), a selective I(Kr) blocker, and intravenous amiodarone (AMD), a multi-channel (including I(Kr) blocking) blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arrhythmia with severe heart failure has not been established. Intravenous AMD might be effective for arrhythmias refractory to NIF in patients with severe heart failure. Here, we report that intravenous amiodarone was effective in the treatment of nifekalant-resistant in a group of arrhythmia patients with severe heart failure. Methods: Eleven severe heart failure patients who had received intravenous AMD for treatment of NIF-resistant arrhythmias were included in this study, and retrospective analysis was performed. Clinical efficacy (terminative and preventive effects on arrhythmia) of intravenous AMD was evaluated. Results: All cases were emergent cases and had depressed left ventricular ejection fraction (30 ± 13%). Clinical arrhythmias were ventricular fibrillation (VF) in four patients, ventricular tachycardia (VT) in six patients, and atrial fibrillation (AF) in one patient. NIF was administered to all patients by intravenous injection. After administration of NIF, VT/VF/AF was terminated in seven of the 10 patients, but a preventive effect was not obtained in any of the patients (NIF-resistance). Intravenous AMD (maintenance dose: 484 ± 166 mg/day) was effective both in termination (80%) and in prevention (80%) of VT/VF events in those patients. It was also effective in termination (80%) and prevention (60%) of AF events refractory to NIF. During continuous AMD administration, no significant adverse effects or proarrhythmic effects were observed in any of the patients. Five patients died within one month, but there was no arrhythmic deaths. Conclusions: Intravenous AMD was effective in NIF-resistant lethal arrhythmias and was relatively safe in emergent cases with severe heart failure. MDPI 2011-05-31 /pmc/articles/PMC4055956/ http://dx.doi.org/10.3390/ph4060794 Text en © 2011 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Article
Nakagawa, Koji
Nakamura, Kazufumi
Kusano, Kengo Fukushima
Nagase, Satoshi
Tada, Takeshi
Murakami, Masato
Hata, Yoshiki
Morita, Hiroshi
Kohno, Kunihisa
Hina, Kazumasa
Ujihira, Tohru
Ohe, Tohru
Ito, Hiroshi
Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title_full Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title_fullStr Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title_full_unstemmed Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title_short Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure
title_sort use of intravenous amiodarone in the treatment of nifekalant-resistant arrhythmia: a review of 11 consecutive cases with severe heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055956/
http://dx.doi.org/10.3390/ph4060794
work_keys_str_mv AT nakagawakoji useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT nakamurakazufumi useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT kusanokengofukushima useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT nagasesatoshi useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT tadatakeshi useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT murakamimasato useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT hatayoshiki useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT moritahiroshi useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT kohnokunihisa useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT hinakazumasa useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT ujihiratohru useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT ohetohru useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure
AT itohiroshi useofintravenousamiodaroneinthetreatmentofnifekalantresistantarrhythmiaareviewof11consecutivecaseswithsevereheartfailure