Fosphenytoin for Control of Electrical Storm in Acute Myocardial Infarction and Purkinje fiber Mediated Arrhythmias

Rai, Maneesh K and Pai, Narasimha D and Prabhu, Mukund A and Kamath, Padmanabh K and Kamath, Ramanath L (2018) Fosphenytoin for Control of Electrical Storm in Acute Myocardial Infarction and Purkinje fiber Mediated Arrhythmias. PACE - Pacing and Clinical Electrophysiology, 41 (7). pp. 707-712. ISSN 01478389

[img] PDF
Fosphenytoin for Control of Electrical Storm in Acute.pdf - Published Version
Restricted to Registered users only

Download (834kB) | Request a copy
Official URL: https://onlinelibrary.wiley.com/loi/15408159

Abstract

Background: Purkinje Fibre mediated Arrhythmias in the setting of Acute Myocardial Infarction are poorly responsive to conventional anti-arrhythmic therapy, increases overall mortality and often requires Radiofrequency ablation (RFA) for control. In this study we report the use of intravenous Fosphenytoin for the control of arrhythmic storm in patients with Acute Myocardial Infarction. Methods and Results: 6 patients with Acute Myocardial Infarction (5 AW/ 1 LW) and Purkinje Triggered ventricular arrhythmias refractory to conventional anti-arrhythmics were treated with intravenous Fosphenytoin (600 mg-1 gm) before considering RFA. Arrhythmia control was obtained in all patients after the initial bolus dose. Breakthrough episodes were seen in 5/6 within 24-36 hrs of the initial bolus, necessitating a second bolus. Complete arrhythmia control was obtained in all patients within 72 hrs and 5/6 patients were successfully discharged from the hospital. One patient succumbed to sepsis in hospital while another patient succumbed to Sub Dural Hematoma after 3 months. Conclusions: Intravenous Fosphenytoin should be considered before RFA for control of Purkinje fibre mediated refractory arrhythmias in Acute Myocardial Infarction patients.

Item Type: Article
Uncontrolled Keywords: Electrical Storm, Purkinje fibre, Acute Myocardial Infarction
Subjects: Medicine > KMC Mangalore > Cardiology
Depositing User: KMCMLR User
Date Deposited: 17 Jan 2019 11:17
Last Modified: 17 Jan 2019 11:17
URI: http://eprints.manipal.edu/id/eprint/153058

Actions (login required)

View Item View Item