[Nifekalant hydrochloride as an effective treatment for postoperative ischemic heart disease]

Area of Science:

• Cardiology
• Pharmacology

Background:

• Postoperative ventricular arrhythmias pose a significant risk, especially in patients with pre-existing reduced left ventricular function.
• Uncontrolled ventricular tachycardia (VT) and ventricular fibrillation (Vf) can be life-threatening, necessitating effective therapeutic interventions.

Observation:

• Two cases involving elderly patients who developed sustained VT and Vf after coronary artery bypass grafting (CABG) are presented.
• Initial treatments with lidocaine hydrochloride and magnesium sulfate were ineffective in managing the arrhythmias in both patients.

Findings:

• Nifekalant hydrochloride successfully terminated sustained VT and Vf in both patients, without causing hypotension.
• The drug demonstrated efficacy even when standard antiarrhythmic agents failed, highlighting its potential in refractory cases.
• Nifekalant hydrochloride possesses an inotropic effect, which is beneficial for patients with compromised left ventricular function.

Implications:

• Nifekalant hydrochloride represents a valuable new therapeutic option for managing uncontrollable VT and Vf, particularly in cardiac surgery patients.
• Its efficacy in patients with reduced left ventricular function suggests a broader role in managing complex cardiac arrhythmias.
• Further investigation into nifekalant hydrochloride's safety and efficacy profile is warranted for its integration into clinical practice.