Report on therapy
Treatment of ventricular fibrillation and other acute arrhythmias with bretylium tosylate

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Abstract

In a pilot study of 30 consecutive patients, bretylium tosylate was found an effective therapeutic agent for treating ventricular fibrillation and other arrhythmias, particularly of ventricular origin. It was of clear value as an adjunct in the treatment of patients with ventricular fibrillation and ventricular tachycardia that had been resistant to other drugs and electrical countershock. In 5 patients bretylium was considered to be livesaving. In 27 patients suppression of the arrhythmia occurred within five minutes to several hours after initial treatment. In 2 the response was delayed until a second dose was given; in a third the arrhythmia was not reversed for seven hours. The duration of antiarrhythmic action was relatively long, lasting from 10 to 20 hours after a dose. Recurrence of the arrhythmia after this period could be suppressed by an additional dose. Unlike all other known antiarrhythmic agents that suppress myocardial contractile strength, bretylium is positively inotropic and normally augments cardiac output. The side effect of orthostatic hypotension usually requires the patient to be kept in bed.

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This study was supported in part by U. S. Public Health Service Grant HE 06314.

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