Abstract
In patients with early repolarization syndrome (ERS), pharmacological therapy may be necessary in patients with frequent delivery of shocks from implantable cardioverter-defibrillator (ICD) due to ventricular fibrillation (VF). In cases of electrical storm, intravenous isoproterenol infusion has been shown to be most effective. Isoproterenol seems to be effective in restoring the action potential dome in the epicardium, because it markedly increases ICa secondary to elevation of intracellular levels of cyclic AMP. It is also effective by indirect suppression of Ito due to its ability to increase the heart rate. Following acute phase, oral quinidine has been reported to prevent the recurrence of VF. Quinidine is a class I antiarrhythmic agent. However, it potently blocks Ito, leading to the restoration of the action potential dome, a normalized ER, and prevents the occurrence of VF. An alternative therapy may be the administration of cilostazol and its combination with bepridil.
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Takahashi, N., Kondo, H., Shinohara, T. (2018). Acute and Chronic Pharmacological Therapy for ERS. In: Shimizu, W. (eds) Early Repolarization Syndrome. Springer, Singapore. https://doi.org/10.1007/978-981-10-3379-7_9
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DOI: https://doi.org/10.1007/978-981-10-3379-7_9
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