| Nifekalant versus lidocaine for in-hospital shock-resistant ventricular fibrillation or tachycardia. | |
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MedLine Citation:
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PMID: 19913983 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the efficacy and safety of nifekalant, a pure class III anti-arrhythmic drug, and lidocaine in patients with shock-resistant in-hospital ventricular fibrillation (VF) or ventricular tachycardia (VT). PATIENTS AND METHODS: Between August 2005 and March 2008, we conducted a prospective, two-arm, cluster observational study, in which participating hospitals were pre-registered either to the nifekalant arm or the lidocaine arm. Patients were enrolled if they had in-hospital VF or VT resistant to at least two defibrillation shocks. Congenital or drug-induced long QT syndrome was excluded. The primary end-point was termination of VF or VT with/without additional shock. The secondary end-points were return of spontaneous circulation (ROSC), 1-month survival and survival to hospital discharge. We also assessed the frequency of adverse events, including asystole, pulseless electrical activity and torsade de pointes. RESULTS: In total, 55 patients were enrolled. After nifekalant, 22 of 27 patients showed termination of VF or VT, as compared with 15 of 28 patients treated with lidocaine with/without additional shock (odds ratio (OR): 3.8; 95% confidence interval (CI): 1.1-13.0; P=0.03). Twenty-three of 27 patients given nifekalant showed ROSC, as compared with 15 of 28 patients given lidocaine (OR: 5.0; 95% CI: 1.4-18.2; P=0.01). There was no difference in 1-month survival or survival to hospital discharge between the nifekalant and lidocaine arms. There was a higher incidence of asystole with lidocaine (7 of 28 patients) than with nifekalant (0 of 27 patients) (P=0.005). Torsade de pointes was not observed. CONCLUSION: Nifekalant was more effective than lidocaine for termination of arrhythmia and for ROSC in patients with shock-resistant in-hospital VF or VT (umin-CTR No. UMIN 000001781). |
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Authors:
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Tsuyoshi Shiga; Keiji Tanaka; Rinya Kato; Mari Amino; Yuji Matsudo; Toshihiro Honda; Koichi Sagara; Atsushi Takahashi; Takao Katoh; Mitsuyoshi Urashima; Satoshi Ogawa; Teruo Takano; Hiroshi Kasanuki; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2009-11-13 |
Journal Detail:
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Title: Resuscitation Volume: 81 ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-02-01 Completed Date: 2010-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 47-52 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. mshiga@hij.twmu.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anti-Arrhythmia Agents / therapeutic use* Chi-Square Distribution Female Humans Lidocaine / therapeutic use* Male Middle Aged Prospective Studies Pyrimidinones / therapeutic use* Statistics, Nonparametric Survival Rate Tachycardia, Ventricular / drug therapy*, physiopathology, therapy Treatment Outcome Ventricular Fibrillation / drug therapy*, physiopathology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 0/Pyrimidinones; 130656-51-8/MS 551; 137-58-6/Lidocaine |
| Investigator | |
Investigator/Affiliation:
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A Takara / ; Y Endo / ; T Yamamoto / ; Y Iwasaki / ; R Kubo / ; Y Matsuyama / ; N Koike / ; A Ohmura / ; T Ueda / ; R Sugiura / ; T Oka / ; R Funada / ; M Nagashima / ; Y Uchida / ; S Takase / ; T Honda / ; T Takano / ; S Ogawa / ; H Kasanuki / ; K Tanaka / ; T Shiga / ; S Hosoda / ; K Ueda / ; K Otsuka / ; R Katoh / ; Y Kobayashi / ; N Matsuda / ; M Urashima / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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