Use of supra‐therapeutic phenytoin for management of ventricular arrhythmias in children: Case series and literature review

Abstract

Phenytoin is a versatile drug with utility in neurological, dermatological, and even cardiac disease processes. Though phenytoin is widely available due to its excellent anti‐epileptic properties, it is now rarely used as an antiarrhythmic. Phenytoin has well‐studied sodium‐channel blocking abilities which can be taken advantage of to treat ventricular arrhythmias. Thus, it should remain in the arsenal of antiarrhythmics for any electrophysiologist. We present two cases of intractable ventricular arrhythmia in children that were controlled with phenytoin at supra‐therapeutic serum levels, preventing the need for heart transplantation.