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Low doses of intravenous epinephrine for refractory sustained monomorphic ventricular tachycardia.
MedLine Citation:
PMID:  23110246     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
We report three cases of sustained monomorphic ventricular tachycardia (VT) in the setting of coronary artery disease, resistant to beta-blockers in two patients and to amiodarone in all, successfully terminated by low doses of intravenous (IV) epinephrine. VT was the first manifestation of coronary artery disease in one patient, whereas the other two patients had a previous history of myocardial infarction and were recipients of an implantable cardioverter-defibrillator (ICD). One of these two patients experienced an arrhythmic storm. All had hemodynamic instability at the time of epinephrine administration. A single slow administration of IV epinephrine (0.5 to 1 mg administered over 30 to 60 s) restored sinus rhythm after 30-90 s with only minor side effects. In the ICD patient with recurrent VT and several cardioversions due to transformation of VT to ventricular fibrillation, epinephrine injection led to the avoidance of further shocks. Although potentially harmful, low doses of IV epinephrine used alone or in combination with beta-blocker treatment and electrical cardioversion may be an alternative effective therapy for sustained monomorphic VT refractory to amiodarone. The role of epinephrine in the termination of VT should be studied further, especially in patients pre-treated with amiodarone in combination with beta-blockers.
Authors:
Aimé Bonny; Antonio De Sisti; Manlio F Márquez; Richard Megbemado; Françoise Hidden-Lucet; Guy Fontaine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of cardiology     Volume:  4     ISSN:  1949-8462     ISO Abbreviation:  World J Cardiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-30     Completed Date:  2012-10-31     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101537090     Medline TA:  World J Cardiol     Country:  China    
Other Details:
Languages:  eng     Pagination:  296-301     Citation Subset:  -    
Affiliation:
Aimé Bonny, Antonio De Sisti, Françoise Hidden-Lucet, Guy Fontaine, Hôpital Pitié-Salpêtrière, Unité de Rythmologie, 47-83 Boulevard de l'Hôpital, 75651 Paris, France.
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