Why the study?
Phenytoin has well-studied sodium-channel blocking abilities useful for ventricular arrhythmias, but is now rarely used as an antiarrhythmic.
Does phenytoin at supra-therapeutic serum levels control intractable ventricular arrhythmias in children?
Does phenytoin at supra-therapeutic serum levels control intractable ventricular arrhythmias in children?
Supra-therapeutic phenytoin may be an effective rescue therapy for intractable ventricular arrhythmias in children, potentially avoiding heart transplantation.
Phenytoin may aid select refractory ventricular arrhythmias; hypothesis-generating and should not yet change practice.
Phenytoin is a versatile drug with utility in neurological, dermatological, and even cardiac disease processes. Though phenytoin is widely available due to its excellent anti-epileptic properties, it is now rarely used as an antiarrhythmic. Phenytoin has well-studied sodium-channel blocking abilities which can be taken advantage of to treat ventricular arrhythmias. Thus, it should remain in the arsenal of antiarrhythmics for any electrophysiologist. We present two cases of intractable ventricular arrhythmia in children that were controlled with phenytoin at supra-therapeutic serum levels, preventing the need for heart transplantation.
No takes yet. Share an insight, caveat, or question.
Bhansali et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: