Related Experiment Videos
[Effective low-dose amiodarone therapy for ventricular tachycardia complicated with ischemic heart disease and poor
Insights
Low-dose amiodarone effectively treated recurrent ventricular tachycardia in a patient with ischemic heart disease and poor left ventricular function. This approach managed arrhythmia symptoms without observed side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ischemic heart disease with poor left ventricular function and ventricular tachycardia presents significant therapeutic challenges.
- Standard antiarrhythmic agents (Vaughan Williams classification Ia and Ib) were ineffective in managing recurrent ventricular tachycardia in this patient.
Observation:
- A 71-year-old male patient with ischemic heart disease and severely reduced left ventricular ejection fraction (24%) experienced recurrent ventricular tachycardia and pre-syncope despite coronary artery bypass surgery.
- The patient had total occlusions in the right coronary artery (segment 3) and left anterior descending artery (segment 6), with a 75% occlusion in segment 13.
Findings:
- Low-dose amiodarone (100 mg/day after a 2-week loading dose of 200 mg/day) was initiated for persistent ventricular tachycardia.
- Amiodarone significantly decreased the patient's arrhythmia symptoms, with no adverse side effects reported during the treatment period.
Implications:
- Low-dose amiodarone can be a valuable therapeutic option for managing refractory ventricular tachycardia in patients with ischemic heart disease and left ventricular dysfunction.
- This case highlights the potential efficacy and tolerability of amiodarone in complex cardiovascular conditions where other treatments have failed.
Abstract:
A 71-year-old man who had ischemic heart disease with poor left ventricular function and ventricular tachycardia was admitted to hospital for evaluation. Cardiac catheterization was performed on August 19, 1996, and right coronary arteriography revealed total occlusion at segment 3. Left coronary arteriography revealed total occlusion at segment 6, and a lesion at segment 13 was 75% occluded. Partial collateral flow from the right ventricular branch to the left anterior descending artery was demonstrated, and the left ventricular ejection fraction was 24%. Recurrent ventricular tachycardia followed by pre-syncope occurred from August 23, 1996, and the patient underwent emergency coronary artery bypass surgery to the left anterior descending artery and circumflex artery using saphenous vein grafts. Ventricular tachycardia followed by pre-syncope occurred frequently after the bypass surgery, and antiarrhythmic agents (Vaughan Williams classification Ia and Ib groups) were ineffective. He received amiodarone (100 mg/day after a loading dose of 200 mg/day for 2 weeks) from September 6, 1996. His symptoms of arrhythmia decreased, and side effects have not been observed. Low-dose amiodarone was effective in this case of ischemic heart disease with left ventricular dysfunction and sustained ventricular tachycardia.