Cor Vasa 2018, 60(5):e452-e455 | DOI: 10.1016/j.crvasa.2017.06.011

Mexiletine as one effective alternative for antiarrhythmic drugs and ablation resistant electrical storm - A case report

Martyna Zaleska^a, Maria Różańska^a, Olga Możeńska^a, Dariusz Artur Kosior^b,*

^a Department of Cardiology and Hypertension, Central Research Hospital, The Ministry of the Interior, Wołoska 137, 02-507 Warsaw, Poland

^b Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawińskiego 5, 02-106 Warsaw, Poland

We present case of 78-year-old male transferred to our Department due to multiple episodes of malignant ventricular arrhythmias refractory to previous antiarrhythmic treatments (device settings optimization, amiodarone treatment, lidocaine infusion and optimal pharmacotherapy). Additionally, patient had ischemic end-stage heart failure and implanted CRT-D. We excluded secondary causes of electrical storm and due to inefficacy of medical therapy, we applied radiofrequency ablation. During 1st day after procedure life-threatening VT/VF recurred. As our last choice, we modified therapy and introduced mexiletine, what resulted in complete disappearance of complex ventricular arrhythmias.
In case of amiodarone inefficacy mexiletine may be considered effective alternative antiarrhythmic drug.

Keywords: Ablation; Heart failure; Implantable cardioverter-defibrillator; Mexiletine; Ventricular arrhythmia

Received: December 29, 2016; Accepted: June 21, 2017; Published: October 1, 2018  Show citation