Use of mexiletine in therapy-refractory recurrent ventricular tachycardia storm

Electrical storm due to recurrent ventricular tachycardias (VTs) is a life-threatening arrhythmic emergency. The authors present a case report of a 69-year-old male patient with VT storm of non-ischemic etiology. Despite optimal medical treatment escalated by amiodarone antiarrhythmic drug therapy,...

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Published inHerzschrittmachertherapie & Elektrophysiologie Vol. 34; no. 4; pp. 326 - 329
Main Authors Szonyi, Mihaly D., Pap, Robert, Vamos, Mate
Format Journal Article
LanguageEnglish
Published Heidelberg Springer Medizin 01.12.2023
Subjects
Cardiac Imaging
Cardiac Surgery
Cardiology
Case Reports
Medicine
Medicine & Public Health
Ventricular arrhythmias
Antiarrhythmic drugs
Kammertachykardie
Electric storm
ICD
Mexiletine
Antiarrhythmische Medikamente
Mexiletin
Elektrischer Sturm
Ventrikuläre Arrhythmien
Natriumkanalblocker
Sodium channel blocker
VT
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Summary:Electrical storm due to recurrent ventricular tachycardias (VTs) is a life-threatening arrhythmic emergency. The authors present a case report of a 69-year-old male patient with VT storm of non-ischemic etiology. Despite optimal medical treatment escalated by amiodarone antiarrhythmic drug therapy, the patient experienced multiple implantable cardioverter defibrillator (ICD) shocks. An electrophysiological study revealed an epicardial substrate; however, considering the patient’s extreme obesity and active anticoagulant effect, catheter ablation was deemed to be unfeasible. Subsequently, mexiletine was added to the patient’s drug regimen, resulting in successful control of arrhythmias during the following 6 months. Although the most recent European guidelines for the management of patients with ventricular arrhythmias mention mexiletine only for the treatment of LQT3 patients, its use for treatment-refractory VT storm seems to also be an important indication area.
Bibliography:ObjectType-Case Study-2
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ISSN:0938-7412
1435-1544
DOI:10.1007/s00399-023-00976-x