[Successful hybrid therapy combined with oral bepridil and ICD in a patient with amiodarone refractory life-threatening ventricular tachyarrhythmia associated with ischemic cardiomyopathy]

J UOEH. 2002 Sep 1;24(3):337-43. doi: 10.7888/juoeh.24.337.
[Article in Japanese]

Abstract

A 68-year-old man was admitted to our hospital for the treatment of angina and ventricular tachyarrhythmia. A coronary and left ventricular angiography showed coronary artery disease and ischemic cardiomyopathy with severe left ventricular dysfunction. A percutaneous transluminal coronary angioplasty was performed successfully in the right coronary artery and his angina symptoms disappeared. However, ventricular tachycardia (VT)/ventricular fibrillation (VF) occurred spontaneously and converted to sinus rhythm with direct current shock (300 J). Oral amiodarone (200 mg/day) and continuous intravenous infusion of nifekalant and lidocaine were started. In addition, a dual chamber implantable cardioverter defibrillator (ICD) for his VT/VF was implanted. However, VT/VF occurred repeatedly after discontinuation of nifekalant. After the administration of bepridil (200 mg/day), VT/VF was completely prevented without nifekalant administration. The hybrid therapy with ICD and oral bepridil is very useful for the treatment of amiodarone resistant ventricular tachyarrhythmia.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Administration, Oral
  • Aged
  • Bepridil / administration & dosage*
  • Defibrillators, Implantable*
  • Humans
  • Male
  • Myocardial Ischemia / complications*
  • Tachycardia, Ventricular / therapy*
  • Ventricular Fibrillation / therapy*

Substances

  • Bepridil