Nifekalant in the treatment of life-threatening ventricular tachyarrhythmias

Table 1 Efficacy of antiarrhythmic drugs in cardiac arrest victims with persistent ventricular tachycardia/fibrillation

First author	Type of study	n	Drug used	Termination of arrhythmia	Other complications	TdP	Survival
Human studies
Amino et al[25]	Out of hospital cardiac arrest with refractory VT/VF to epinephrine and lidocaine	32	11 nifekalant	9 (82%)		0	2 (18%)
			21 lidocaine	4 (19%)		0	0
Yoshioka et al[26]	Out of hospital cardiac arrest with refractory VT/VF to epinephrine and lidocaine	36	12 nifekalant	9 (75%)	4 sinus suppression (sinus bradycardia and sinus pause)	0	2 (17%) (24 h)
			24 lidocaine and magnesium and procainamide if necessary	4 (17%)
	In hospital cardiac arrest with refractory VT/VF to epinephrine and lidocaine	29	9 nifekalant	8 (89%)	0 sinus suppression (sinus bradycardia and sinus pause)	1	4 (44%) (24 h)
			20 lidocaine and magnesium and procainamide if necessary	15 (75%)
Tahara et al[27]	Out of hospital cardiac arrest with refractory VF to pinephrine	120	55 nifekalant			0	37 (67%) (hospital admission)
							29 (53%) (24 h)
			65 lidocaine			0	24 (37%) (hospital admission)
							20 (31%) (24 h)
Igarashi et al[28]	Out of hospital cardiac arrest (VF)	22	8 nifekalant	5 (61.5%)
			14 lidocaine	2 (14.3%)
Yasuda et al[29]	Out of hospital cardiac arrest with refractory VT/VF to epinephrine	14	14 nifekalant	12 (86%)		1	11 (79%) (hospital admission)
Shiga et al[30]	In hospital cardiac arrest with refractory VT/VF	55	27 nifekalant	22 (81%)	0 Asystole 2 PEA 1 QT>0.55	0	13 (48%) (1-mo survival)
							12 (44%) (survival to discharge)
			28 lidocaine	15 (54%)	7 Asystole 1 PEA 0 QT>0.55	0	9 (32%) (1-mo survival)
							8 (29%) (survival to discharge)
Amino et al[31]	Out of hospital cardiac arrest with refractory VF	30	15 nifekalant	7 (47%)	0 Thyroid dysfunction	0	7 (47%) (hospital admission)
							4 (27%) (survival to discharge)
			15 amiodarone	10 (67%)	1 Thyroid dysfunction	0	10 (67%) (hospital admission)
							8 (53%) (survival to discharge)
Animal studies
Ji et al[32]	4 min of untreated VF	36	12 saline	7 (58.3%) ROSC		0	2 (17%) (24 h)
			12 nifekalant	12 (100%) ROSC		1	8 (67%) (24 h)
			12 amiodarone	12 (100%) ROSC		0	9 (75%) (24 h)

VT/VF: Ventricular tachycardia/fibrillation; TdP: Torsades de pointes.