Intravenous Diphenylhydantoin Sodium (Dilantin) in Cardiac Arrhythmias

¹ Assistant Resident in Medicine, Albert Einstein College of Medicine-Bronx Municipal Hospital Center

Fifty-four patients received intravenous diphenylhydantoin on 57 occasions for abnormal cardiac rhythm. Nineteen of 23 who had digitalis-induced arrhythmias responded with abolition or marked suppresion of a ventricular ectopic focus, or with conversion of supraventricular arrhythmias to a regular sinus mechanism. Of 28 patients whose arrhythmias were unrelated to digitalis, seven responded favorably; in three patients, the relationship to digitalis was unclear, and one of the responded.

Rapidity of action and relative paucity of side-effects, when it is used properly, make DPH an effective antiarrhythmic agent.

On the basis of these results, DPH is recommended in the treatment of digitalis-induced arrhythmias. It may also be useful in the of not associated with digitalis intoxication. The role of DPH in the management of other arrhythmias, including those associated with cardiac surgery, catheterization, myocardial infarction, and cardiac arrest, should continue to be investigated.