Ventricular fibrillation. A complication and hazard of transcatheter obliteration of the renal artery with absolute ethanol in dogs.

Selective renal artery embolization with absolute ethanol was performed without balloon occlusion in a series of 11 healthy mongrel dogs. Electrocardiogram, blood ethanol level, heart rate, and blood pressure of the aorta and pulmonary artery were monitored. Ventricular extrasystoles and/or ventricular fibrillation occurred in six of the 11 dogs, to which absolute ethanol in doses ranging from 0.09 to 0.40 ml/kg was administered. In three of these six animals, the electrocardiograms showed only ventricular extrasystoles after intra-arterial bolus injection of absolute ethanol at doses of less than 0.15 ml/kg and subsequent recovery to a normal sinus rhythm. Ventricular fibrillation subsequent to ventricular extrasystoles immediately after intra-arterial injection of absolute ethanol at doses of more than 0.18 ml/kg occurred in three. In five of eight dogs that survived after alcohol injection in this series, a severe hypertensive response was observed. Absolute ethanol has the potential hazard of causing ventricular arrhythmia. Thus, careful observations should be undertaken in clinical therapeutic application of this agent, particularly in the absence of balloon occlusion, absolute ethanol should never be used without monitoring the electrocardiogram.