Myocardial Infarction

Leonard, Archives of Internal Medicine (1958),221 was the first to report the use of PHT for the control of ventricular hyperirritability complicating myocardial infarction.

221. Leonard, W. A., Jr., The use of diphenylhydantoin (Dilantin) sodium in the treatment of ventricular tachycardia, A.M.A. Arch. Intem. Med., 101: 714-717, 1958.

Mercer and Osborne, Annals of Internal Medicine (1967),248 reported the effectiveness of PHT in treating ventricular arrhythmias in 67 of 101 patients with acute myocardial infarction complicated by arteriosclerotic heart disease.

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

Bashour, Lehmann and Prati, Journal of Laboratory and Clinical Medicine (1967),2151 in a controlled study, report the preventive use of PHT in acute myocardial infarction. In the treated group of thirty patients, PHT reduced both the incidence and severity of ventricular arrhythmias. Twenty did not develop ventricular arrhythmias. In the ten who did have ventricular tachycardia, the episodes were less severe when compared with the control group and only one persisted as long as eight hours. In the control group of nineteen patients, twelve developed ventricular tachycardia and two ventricular fibrillation. (See also Ref. 2150.)

2151. Bashour, F.A., Lehmann, J. and Prati, R., Prophylactic use of Dilantin in acute myocardial infarction, J. Lab. Clin. Med., 70(5): 893,1967.
2150. Bashour, F.A., ]ones, E. and Edmonson, R., Cardiac arrhythmias in acute myocardial infarction: 11. Incidence of the common arrhythmias with special reference to ventricular tachycardia, Dis. Chest, 51: 520-9, 1967.

Hansen and Wagener, Munchener Medizinische Wochenschrift (1969),1120 reported the effective use of PHT in the treatment of cardiac arrhythmias following myocardial infarction. In fifty patients who had a fresh myocardial infarction, PHT was slowly injected intravenously with excellent tolerance.

1120. Hansen, H. W. and Wagener, H. H., Sodium diphenylhydantein for the treatment of cardiac arrhythmias, Munchen Med. Wschr., 111: 417-421, 1969.

Eddy and Singh, British Medical Journal (1969),987 reported the successful use of intravenous PHT in the treatment of cardiac arrhythmias in eighteen of twenty-one patients who suffered acute myocardial infarction.

987. Eddy, J. D. and Singh, S. P., Treatment of cardiac arrhythmias with phenytoin, Brit. Mod. J., 4: 270-273, 1969.

Luckmann, Hossmann, Dorner, Rothenberger and Wichert, Presented at the Tbird Konigsteiner Symposium in Hamburg (1973),2729 used intravenous PHT in twenty-six patients with either ventricular or supraventricular extrasystoles resulting from acute myocardial infarction. Of the twenty patients with ventricular extrasystoles, fourteen had elimination of the arrhythmia and three had reduction in extrasystoles. In six patients, supraventricular extrasystoles were eliminated in two and reduced in three.

2729. Luckmann, E., Hossmann, H., Dorner, V., Rothenberger, W., Wichert, P. V., Clinical experience with diphenylhydantoin in ventricular and supraventricular extrasystoles, Aktuelter Stand der Pathosphysiologie, Diagnostik und Therapie von Herzrhythmusstorungen, Haan, D., Runge, M., Eds., Desitin Werk, Hamburg, 165-73, 1973.

Yang, Journal of the Kansas Medical Society (1973),1705 states, “When faced with an intractable ventricular tachycardia and bewildered by the failure of treatment, try PHT; it could be life saving.” The author reports on a case of intractable ventricular tachycardia following acute myocardial infarction. Procainamide, large doses of lidocaine, repeated DC counter-shock, and propranotol failed to convert this life threatening cardiac arrhythmia. PHT abolished the persistent ventricular tachycardia, and also permitted continuous digitalization when digitalis was so critically needed.

1705. Yang, C. P., Persistent ventricular tachycardia. The use of diphenyihydantoin, J. Kansas Med. Soc., 74: 418-421, 1973.

See also: Cardiac Arrhythmias