Use of supra-therapeutic phenytoin for management of ventricular arrhythmias in children: Case series and literature review.

Suneet Bhansali, Reina Bianca M Tan, Maria Spilios, Frank Cecchin

Journal: Pacing and clinical electrophysiology : PACE 2022;45(12):1385-1389

PMID: 35903996

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Abstract

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.

Address: Division of Pediatric Cardiology, NYU Langone Health, New York, New York, USA.; Department of Pharmacy, NYU Langone Health, New York, New York, USA.

DOI: 10.1111/pace.14565

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MeSH Terms: Child, Humans, Phenytoin