Malignant ventricular tachycardia during propafenone treatment in a child with junctional automatic tachycardia: effectiveness of intravenous molar sodium lactate
| Autor: | Jean-Claude Pc-Tier, Pierre Bustany, Gilles Grollier, Michel Iselin, Patrice Scanu, Danièle Guilleman, Jean-Michel Hurpe |
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| Rok vydání: | 1991 |
| Předmět: |
Tachycardia
medicine.medical_specialty Heart disease Bundle-Branch Block Shock Cardiogenic Propafenone Ventricular tachycardia Electrocardiography Internal medicine medicine Humans cardiovascular diseases Lactic Acid medicine.diagnostic_test Bundle branch block business.industry General Medicine Hyperpolarization (biology) medicine.disease Atrioventricular node medicine.anatomical_structure Anesthesia Child Preschool cardiovascular system Cardiology Atrioventricular Node Lactates Female medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 14(5 Pt 1) |
| ISSN: | 0147-8389 |
| Popis: | Propafenone may aggravate the preexisting arrhythmia or induce another one. Usually, such proarrhythmic effects occur in patients with spontaneous ventricular arrhythmias and/or coronary heart disease with poor left ventricular function. We report the case of a 5-year-old girl with junctional automatic tachycardia and no structural heart disease, in whom malignant ventricular tachycardia occurring during propafenone treatment could be terminated by molar sodium lactate (MSL) infusion. The serum propafenone level obtained before MSL infusion was within the therapeutic range. Two hypothesis could explain the beneficial effects of MSL in our patient: (1) alkalinization facilitates the cell membrane hyperpolarization and thus can decrease the voltage-dependent effect of Class Ic drugs, (2) alkalinization could displace propafenone from its tissue receptor sites by an increase in the nonionized fraction. |
| Databáze: | OpenAIRE |
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