 |
|
Management of Ventricular Arrhythmias
Detection, Drugs, and Devices
David S. Cannom, MD;
Eric N. Prystowsky, MD
JAMA. 1999;281:172-179.
Objective To review evaluation and treatment of patients with ventricular arrhythmias, based on recent studies, with an emphasis on randomized controlled trials.
Data Sources MEDLINE search of English-language publications of ventricular arrhythmias and their references from 1966 through April 27, 1998. References to articles were also scanned to broaden the search.
Study Selection Randomized controlled trials and all large nonrandomized trials of arrhythmias and arrhythmia therapy were reviewed. In addition, studies that led to changes in approach to patients with arrhythmias were reviewed.
Data Extraction We reviewed articles jointly for pertinent studies and information.
Data Synthesis The goals of treatment of the patient with ventricular arrhythmias are to suppress symptoms and prevent a fatal event. The steps in providing such therapy include defining the cardiac anatomy, assessing arrhythmia risk through noninvasive or invasive testing, and prescribing treatment based on these results. Patients may be separated into high- and low-risk groups to help identify appropriate treatment. While low-risk groups may benefit from reassurance or medications such as  -blockers or verapamil, high-risk groups have been more difficult to treat. Recent randomized trials of implantable cardioverter defibrillators for ventricular arrhythmias suggest that they may provide better protection for high-risk patients than do antiarrhythmic medications.
Conclusions Treatment and understanding of risk from ventricular arrhythmias have advanced substantially in recent years. Classifying patients as being at high or low risk for fatal arrhythmias allows the physician to identify appropriate treatments for the high-risk patient without exposing the low-risk patient to unnecessary treatment-related risks.
Author Affiliations: Good Samaritan Hospital (Dr Cannom) and the School of Medicine, University of California at Los Angeles (Dr Cannom); Clinical Electrophysiology Laboratory, North Side Cardiology, PL and St Vincent Hospital, Indianapolis, Ind (Dr Prystowsky); and Duke University Medical Center, Durham, NC (Dr Prystowsky).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
January 13, 1999
JAMA. 1999;281(2):203-204.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Real-time assessment of acute myocardial ischaemia by an intra-thoracic 6-lead ECG: evaluation of a new diagnostic option in the implantable defibrillator
Baron et al.
Europace 2006;8:994-1001.
ABSTRACT
| FULL TEXT
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)
Developed in Collaboration With the European Heart et al.
J Am Coll Cardiol 2006;48:e247-e346.
FULL TEXT
ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society
Writing Committee Members et al.
Europace 2006;8:746-837.
FULL TEXT
Primary Prevention of Sudden Cardiac Death: The Time of Your Life
Prystowsky
Circulation 2004;109:1073-1075.
FULL TEXT
Effectiveness of implantable defibrillators for preventing arrhythmic events and death: A Meta-Analysis
Lee et al.
J Am Coll Cardiol 2003;41:1573-1582.
ABSTRACT
| FULL TEXT
Primary Prevention of Sudden Death With Implantable Defibrillator Therapy in Patients With Cardiac Disease: Can We Afford to Do It? (Can We Afford Not To?)
Exner et al.
Circulation 2001;104:1564-1570.
FULL TEXT
A Prophylactic ICD? Who are the patients? What is the device?
Nisam
Europace 2001;3:269-274.
The Utilization of the Implantable Defibrillator--a European Enigma
Camm and Nisam
Eur Heart J 2000;21:1998-2004.
The Rapidly Changing Management of Cardiac Arrhythmias
HAMMILL and HUBMAYR
Am. J. Respir. Crit. Care Med. 2000;161:1070-1073.
FULL TEXT
|
