Management of ventricular arrhythmias: then and now.
OBJECTIVE
To review the changing environment of antiarrhythmic therapy.


METHODS
The majority of articles chosen were written by experts in the field of arrhythmia management. The references include a pilot study, abstracts, original articles and results of study groups. An equal number of sources used in this article were obtained from fellow healthcare professionals and MEDLINE searches.


METHODS
Large, controlled clinical trials in which patient populations had structural heart disease, prior myocardial infarction and/or frequent ventricular premature beats. All were treated with either antiarrhythmic therapy or devices.


RESULTS
Past research in the field of arrhythmia management has indicated that ventricular premature beat suppression is the key to increasing patient survival. After reviewing the results of such pivotal trials as the Cardiac Arrhythmia Suppression Trial, however, the question of whether to initiate therapy remains.


CONCLUSIONS
Several trials investigating the efficacy of antiarrhythmic drugs in decreasing sudden death have yielded disappointing results. These trials have been beneficial, however, in classifying arrhythmias and assessing patient risk. The outcomes of these trials, combined with advances in the treatment of heart disease, provide us with a framework for antiarrhythmic therapy. Additional controlled clinical trials are necessary if we are to learn the best means of increasing survival in ventricular arrhythmia patients.
Bennett
B
B
Cardiology Division, VA Medical Center, Washington, DC 20422.
Singh
S
S
D000200:Action Potentials / Q000187:drug effects; D000465:Algorithms; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000451:nursing; D002986:Clinical Trials as Topic; D004562:Electrocardiography; D006801:Humans; D009733:Nursing Diagnosis; D010347:Patient Care Planning; D015996:Survival Rate
D000889:Anti-Arrhythmia Agents