Nifekalant hydrochloride is a novel class III antiarrythmic agent used especially for malignant VT/VF, which is resistant to electrical defibrillation and lidocaine. We previously reported that this agent restored the sinus rhythm from ventricular fibrillation more successfully than lidocaine. A 60-year-old female was transferred to the Emergency Medical Center of Tokai University Hospital because of cardiac arrest due to ventricular fibrillation. After several unsuccessful attempts at electrical defibrillation at the scene and the emergency room, we administrated nifekalant hydrochloride before lidocaine. With the infusion of nifekalant, the patient was successfully defibrillated. A 57-year-old female also admitted to our hospital with recurrent ventricular fibrillation that was resistant to electrical defibrillation. In situations of VT/VF resistance to electrical defibrillation, lidocaine has been used prior to nifekalant. However, we selected nifekalant first, with which the patient was successfully defibrillated. After the infusion of nifekalant hydrochloride, the sinus rhythm was restored. We concluded that nifekalant hydrochloride is especially effective for recurrent ventricular fibrillation and it should be administrated as early as possible.
