2019年晚发性冠状病毒病后暴发性心肌炎患者使用尼夫卡兰治疗长期心室颤动
Prolonged ventricular fibrillation treated with nifekalant in fulminant myocarditis following late-onset coronavirus disease 2019.
摘要(中文译文)
暴发性心肌炎（FM）是一种危及生命的炎症性心脏病，可迅速进展为心源性休克或致命性心律失常。新型冠状病毒感染（COVID-19）后迟发性暴发性心肌炎较为罕见，而合并持续性心室颤动（VF）的病例则更为罕见。一名既往健康的十几岁晚期男性在COVID-19感染后出现呼吸困难及完全性房室传导阻滞。超声心动图显示左心室射血分数为30%。尽管接受了静脉-动脉体外膜肺氧合及Impella CP支持，患者仍出现持续五天的心室颤动，对胺碘酮及反复除颤均无效。持续静脉输注盐酸尼非卡兰终止了心室颤动并转为窦性心律。心内膜心肌活检显示以CD68巨噬细胞为主的炎症，符合COVID-19相关心肌炎。本病例提示，尼非卡兰可能是治疗COVID-19感染后暴发性心肌炎中危及生命的室性心律失常、同时保留心肌收缩力的一种有价值的治疗选择。
Abstract
Fulminant myocarditis (FM) is a life-threatening inflammatory cardiac disease that can rapidly progress to cardiogenic shock or fatal arrhythmias. Delayed-onset FM following coronavirus disease 2019 (COVID-19) infection is rare and cases complicated by sustained ventricular fibrillation (VF) are exceptional.A previously healthy man in his late teens developed dyspnoea and complete atrioventricular block after COVID-19 infection. Echocardiography revealed a left ventricular ejection fraction of 30%. Despite veno-arterial extracorporeal membrane oxygenation and Impella CP support, he developed persistent VF lasting for five days, refractory to amiodarone and repeated defibrillation. Continuous intravenous infusion of nifekalant hydrochloride terminated VF and converted to sinus rhythm. Endomyocardial biopsy demonstrated CD68 macrophage-predominant inflammation, consistent with COVID-19-associated myocarditis.This case suggests that nifekalant may be a valuable therapeutic option for managing life-threatening ventricular arrhythmias while preserving myocardial contractility in FM following COVID-19 infection.
如何引用
AMA
Satoko Ojima, Takuro Kubozono, Takeko Kawabata, Shin Kawasoe, Satoshi Yamaguchi, Yuito Enokida, et al. Prolonged ventricular fibrillation treated with nifekalant in fulminant myocarditis following late-onset coronavirus disease 2019.. BMJ case reports. 2026; doi:10.1136/bcr-2025-271816.
APA
Satoko Ojima, Takuro Kubozono, Takeko Kawabata, Shin Kawasoe, Satoshi Yamaguchi, Yuito Enokida, et al (2026). Prolonged ventricular fibrillation treated with nifekalant in fulminant myocarditis following late-onset coronavirus disease 2019.. BMJ case reports. https://doi.org/10.1136/bcr-2025-271816
GB/T 7714
Satoko Ojima, Takuro Kubozono, Takeko Kawabata, Shin Kawasoe, Satoshi Yamaguchi, Yuito Enokida, et al. Prolonged ventricular fibrillation treated with nifekalant in fulminant myocarditis following late-onset coronavirus disease 2019.[J]. BMJ case reports, 2026 doi:10.1136/bcr-2025-271816.
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