PREVENTION OF VENTRICULAR TACHYCARDIA AND STOKES-ADAMS SEIZURES IN COMPLETE HEART BLOCK; TREATMENT WITH LARGE DOSES OF INTRAVENOUS ISOPROTERENOL.

Abstract

THE PREFERRED treatment of Stokes-Adams seizures in complete atrioventricular heart block depends on the identification of the causative cardiac disorder by electrocardiography. These disorders, which may be multiple and variable in the same individual, include ventricular asystole, tachycardia, flutter, and fibrillation.1-3 The various methods of treatment of Stokes-Adams seizures in complete atrioventricular heart block include the use of sympathicomimetic amines, kaluretic agents, steroids, molar sodium lactate, oxygen, external and intracardiac pacemakers, and implantable pacemakers.1-6The following case of complete heart block is presented to illustrate the use of increasingly large doses of intravenous isoproterenol hydrochloride to control recurrent Stokes-Adams seizures secondary to ventricular tachycardia without developing evidence of cardiac or systemic toxicity. Report of Case The patient is a 67-year-old woman with known hypertension for the last 13 years, who was found 3⅔ years ago to have congestive heart failure, left ventricular enlargement, and complete atrioventricular heart