Antiarrhythmic therapy for asymptomatic ventricular arrhythmias.
The rationale for treatment of patients with nonsustained asymptomatic ventricular arrhythmias is the theoretical benefit of preventing more serious ventricular arrhythmias and sudden cardiac death. Because of the high costs involved and the serious side effects, such as proarrhythmia, associated with this therapy, the decision to treat this patient group for a potential protective effect must be weighed carefully. Risk factors identifying those patients most likely to have further complications include the presence of heart disease and left ventricular dysfunction, and the relative severity of these conditions. Those patients who fit into high-risk groups are the ones most likely to benefit, although this benefit is still unproved. If antiarrhythmic therapy is given, it is recommended that it be started in the hospital and that the efficacy of treatment be assessed by serial electrophysiologic-pharmacologic testing or noninvasive means. Empiric treatment, especially started out-of-hospital, is discouraged because it is least likely to benefit the patient and most likely to cause harm.
Prystowsky
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EN
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D003645:Death, Sudden / Q000517:prevention & control; D006331:Heart Diseases / Q000150:complications / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans
D000889:Anti-Arrhythmia Agents