VENTRICULAR fibrillation currently curtails clinical use of general body hypothermia at levels below 28 C (86 F) without assistance of extracorporeal circulation. This reaction of the heart to cooling remains as one of the major barriers to achieving safe general body hypothermia.1 Theoretical advantages of achieving intermediate and deep hypothermia continue to spur efforts to achieve such a condition with safety in man.
In man, ventricular tachycardias have been clinically eliminated using sodium diphenylhydantoin (Dilantin Sodium).2-4 Experimentally, Covino et al5 found that the drug reduced the incidence of ventricular fibrillation in hypothermic dogs. Because of its demonstrated potential as an antifibrillatory drug, sodium diphenylhydantoin was given a thorough trial in the experimental laboratory as a prophylactic agent against ventricular fibrillation during intermediate and deep body cooling induced by immersion in ice water.
The use of sodium diphenylhydantoin for treatment of cardiac arrhythmias is not new.
Swan H, Sawyer DC. Prevention of Ventricular Fibrillation During Experimental HypothermiaFailure of Sodium Diphenylhydantoin. Arch Surg. 1967;95(1):23-26. doi:10.1001/archsurg.1967.01330130025005