Cardioversion

Merce and Osborne, Annals of Internal Medicine (1967), ²⁴⁸ in an extensive study of 774 patients with a variety of cardiac arrhythmias, reported the effectiveness of intravenous PHT in the treatment of twenty-one of twenty-three patients with postcardioversion arrhythmias.

248. Mercer, E. N. and Osborne, J. A., The current status of diphenylhydantoin in heart disease, Ann. Intern. Med., 67: 1084-1107, 1967.

Lesbre, Cathala, Salvador, Florio, Lescure and Meriel, Archives des Maladies du Coeur et des Vaisseaux (1969),¹²⁶⁴ as part of an extensive study to investigate the antiarrhythmic value of PHT in a variety of cardiac disturbances, gave PHT to forty patients with atrial fibrillation, prior to cardioversion. A beta-blocking agent was given to a similar group of forty patients. Comparison of the two groups showed to the advantage of PHT.

1264. Lesbre, J. P., Cathala, B., Salvador, M., Florio, R. Lescure, F., and Meriel, P., Diphenylhydantoin and digitalis toxicity, Arch. Mal. Coeur., 62: 412-437, 1969.

Damato, Progress in Cardiovascular Disease (1969),⁹³⁶ pretreated ten digitalized patients, undergoing elective cardioversion, with intravenous PHT (5 mg/kg) fifteen minutes prior to procedure. None of the patients developed ventricular arrhythmias following cardioversion.

936. Damato, A. N., Diphenylhydantoin: pharmacological and clinical use, Progr. Cardiovasc. Dis., 12: 1-15, 1969.

Helfant, Steuffert, Patton, Stein and Damato, American Heart Journal (1969),⁷²⁰ reported that in twelve patients, pretreated with PHT, DC countershock produced regular sinus rhythm with no immediate post-shock arrhythmias.

720. Helfant, R. H., Seuffert, G. W., Patton, R. D., Stein, E., and Damato, A. N., The clinical use of diphenylhydantoin (Dilantin) in the treatment and prevention of cardiac arrhythmias, Amer. Heart J., 77: 315-323, 1969.

Cuan-Perez and Ortiz, Archivos del Instituto de Cardiologia de Mexico (1971),^ss923 found PHT effective in preventing recurrence of fibrillation after cardioversion. The study included 230 cases. PHT was compared with quinidine and propranolol. PHT and the other two drugs acted in similar fashion with regard to percentage of recurrence. However, the authors found PHT the drug of choice because no toxic complications were observed with it, and this was not the case with quinidine and propranolol.

923. Cuan-Perez, M. C. and Ortiz, A., Comparative study of quinidine, propranolol and diphenylhydantoin for preventing recurrence in post-cardioversion auricular fibrillation, Arch. Inst. Cardiol. Mex., 41: 278-284, 1971.

Linde, Turner and Awa, Pediatrics (1972),¹²⁸⁹ in a review, suggest that because of the increased risk in cardioversion following digitalis administration, cardioversion should be preceded by PHT (5 mg/kg) administered intravenously over ten minutes, monitoring the electrocardiogram and blood pressure.

1289. Linde, L. M., Turner, S. W., and Awa, S., Present status and treatment of paroxysmal supraventricular tachycardia, Pediatrics, 50: 127-130, 1972.