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Malignant Ventricular Tachycardia During Propafenone Treatment in a Child with Junctional Automatic Tachycardia: Effectiveness of Intravenous Molar Sodium Lactate
Author(s) -
SCANU PATRICE,
GROLLIER GILLES,
GUILLEMAN DANIELE,
ISELIN MICHEL,
BUSTANY PIERRE,
HURPE JEANMICHEL,
PCTIER JEANCLAUDE
Publication year - 1991
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1991.tb04107.x
Subject(s) - propafenone , medicine , cardiology , ventricular tachycardia , tachycardia , anesthesia , heart disease , atrial fibrillation
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.