Clinical implications of new studies in the treatment of benign, potentially malignant and malignant ventricular arrhythmias

The American Journal of Cardiology
J L Anderson

Abstract

For purposes of clinical management, ventricular arrhythmias have been divided into risk categories of benign, prognostically important (potentially malignant) and malignant. Benign arrhythmias occur in the setting of structurally normal hearts and do not require therapy unless associated with debilitating symptoms. Malignant arrhythmias such as sustained ventricular tachycardia or fibrillation deserve aggressive therapy to prevent recurrence. Arrhythmias occurring in the presence of organic heart disease (often ischemic disease) are frequently asymptomatic but prognostically important as a risk factor for sudden death or cardiac arrest. The common empiric practice to treat such arrhythmias (by about 40 to 50% of cardiologists in the United States) needs to be reassessed in the face of the Cardiac Arrhythmia Suppression Trial. For malignant arrhythmias, class IA agents (procainamide and quinidine) continue to be the standard of treatment, and class IB agents (e.g., mexiletine) may be used as alternative or additive therapy. Class IC agents are used as second-line therapy, especially in the setting of ischemic heart disease. Class III therapy with amiodarone is reserved for refractory patients because of potential toxicity. Sota...Continue Reading

References

Oct 6, 1977·The New England Journal of Medicine·W RubermanS Shapiro
Feb 1, 1979·The American Journal of Cardiology·B Lown
Aug 1, 1987·Journal of the American College of Cardiology·J B KostisC Furberg
Aug 1, 1987·The American Journal of Cardiology·J L AndersonJ Friedman
Dec 1, 1987·British Heart Journal·J G ClelandI Ford
Aug 10, 1989·The New England Journal of Medicine·UNKNOWN Cardiac Arrhythmia Suppression Trial (CAST) Investigators
Jan 24, 1985·The New England Journal of Medicine·H L KennedyR J Goldberg
Mar 1, 1985·Progress in Cardiovascular Diseases·S YusufP Sleight
Mar 1, 1988·The American Journal of Cardiology·UNKNOWN Cardiac Arrhythmia Pilot Study (CAPS) Investigators
Sep 1, 1988·The American Journal of Cardiology·J Morganroth, L N Horowitz
Sep 1, 1986·Journal of the American College of Cardiology·J MorganrothG D Gentzkow
Apr 1, 1985·American Heart Journal·M E RosenthalT Peter
Jan 1, 1983·The American Journal of Cardiology·D A RichardsJ B Uther
Apr 1, 1983·The American Journal of Cardiology·J L AndersonL S Green
Sep 1, 1982·The American Journal of Cardiology·T B GraboysR DeSilva
Sep 22, 1983·The American Journal of Cardiology·J T Bigger
Sep 1, 1983·Journal of Cardiovascular Pharmacology·E Patterson, B R Lucchesi
Feb 1, 1984·The American Journal of Cardiology·J L AndersonJ M Nappi
Sep 22, 1983·The American Journal of Cardiology·C D Furberg
Nov 14, 1984·The American Journal of Cardiology·J T Bigger
Jun 1, 1984·The American Journal of Cardiology·F C Kempf, M E Josephson
Aug 3, 1984·JAMA : the Journal of the American Medical Association·J Morganroth
Jul 1, 1984·The American Journal of Cardiology·J MukharjiD S Raabe
Jun 16, 1983·The New England Journal of Medicine·C D SwerdlowJ W Mason

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Citations

Nov 1, 1991·Journal of Clinical Pharmacology·N Z Kerin
Nov 1, 1990·The American Journal of Cardiology·H L Kennedy
Jul 1, 1997·Hypertension·W B StasonT C Chalmers

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